Form Fm S871 - Parent/guardian Consent Form printable pdf download

Form Fm S871 - Parent/guardian Consent Form

PARENT/GUARDIAN CONSENT FORM

Child's Name (Last)

(First)

(Middle)

Address

City

State

ZIP Code

Name of Facility (Camp/Church/School)

Address

City

State

ZIP Code

Dates of Attendance

As the parent or legal guardian of my child, ___________________________, I hereby

consent for my child to attend and participate in all activities provided as described above.

Print Name

Signature

Date

ADDITIONAL INFORMATION:

Exclude from following Activities:

CHURCH MUTUAL INSURANCE COMPANY AND

ERMES

ARGENT

ATES WISH TO POINT OUT THAT NO WARRANTY ATTACHES TO

THESE DOCUMENTS

AND IN FACT

THESE DOCUMENTS MAY NOT BE APPROPRIATE FOR THE SPECIFIC NEEDS OF A PARTICULAR

ENTITY

THESE DOCUMENTS ARE NOT A SUBSTITUTE FOR GOOD PRACTICE

PROPER SUPERVISION

AND DILIGENT OVERSIGHT

AND CONTROL

THERE IS NO GUARANTEE THAT THESE DOCUMENTS WILL PROTECT ANY FACILITY THAT CHOOSES TO USE THEM

BEFORE USING THESE DOCUMENTS OR ANY SIMILAR DOCUMENTS

YOU SHOULD CONSULT WITH YOUR OWN ATTORNEY TO MAKE

CERTAIN THAT THE DOCUMENT YOU EVENTUALLY USE IS CORRECT AND CURRENT UNDER THE LAW OF YOUR PARTICULAR

JURISDICTION AND THAT THE DOCUMENT MEETS YOUR NEEDS FOR YOUR PARTICULAR SITUATION

FM:S871 (8-2008) HSB

Form Fm S871 - Parent/guardian Consent Form