College & Career Consent Form
Event Information
Date of Event
*
-
Month
-
Day
Year
Date
Name of Event
*
Helen Tubing 7/15/19
Participant's Information
Participant's Name
*
First Name
Last Name
Gender
*
Male
Female
Cell Number
*
E-mail
*
example@example.com
Emergency Contact (Parent/Guardian) Information
Name
*
First Name
Last Name
Cell Number
*
E-mail
*
Does the participant have any allergies, chronic illness, or medical conditions? If yes, please describe.
*
Parent/Guardian Signature
*
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