Civic Armory NW Range Minor Consent Form

11714 Airport Rd, Everett, WA 98204
(425) 265 - 7143
Range@CivivArmoryNW.com
www.westcoastarmorynorth.com

West Coast Armory North has changed names to Civic Armory NW you may see both names while we adjust.
Parent/Legal Guardian Consent Form
Date of Consent

MonthDayYear
Name of Parent/Legal Guardian

First NameLast Name
Name of Minor

First NameLast Name
Name of Temporary Guardian

First NameLast Name
Check box to certify agreement with the use of this form
Parent/Legal Guardian Signature
Date of Parent/Legal Guardian Signature

MonthDayYear
Emergency Contact Number for Parent/Legal Guardian

Area CodePhone Number
Signature of Temporary Guardian
Date of Temporary Guardian Signature

MonthDayYear
*Please Note: This form is only valid for the day it is dated for. Please Double check the date at the top of the form before submitting. Thank you.*
Should be Empty:

Parent/Legal Guardian Consent Form