Urban Youth Conservation Travel / Consent Form

Urban Youth Conservation Travel and Activity Consent Form

This form grants permission to participate in activities organized by Urban Youth Conservation and to travel in vehicles provided by the organization.
1. Youth Information:
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
2. Parent/Guardian Information:
Name*

First NameLast Name
Relationship to Youth
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Medical Information / Allergies
Please list any allergies or medical conditions we should be aware of.
I, the parent/guardian, give permission for my child to participate in Urban Youth Conservation activities and travel in vehicles provided by the organization. I release the organization from liability in case of accidents during approved activities.
Signature*

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Date

MonthDayYear
Date
I acknowledge that my child may participate in activities such as paintball or other supervised outdoor events.
Should be Empty:

Urban Youth Conservation Travel and Activity Consent Form