Riverside Youth Guardian Consent Form (2021-2022)
2021-2022 Guardian Consent Form

Thank you for entrusting your youth student with us. Please fill out the following information. This information is to help Riverside Youth keep in touch with parents/guardians about upcoming youth events, changes, and/or cancellations. We also need to have all information in case of emergencies. Also, if we need to drive your student anywhere we must have this form. Please keep us updated if any information changes.
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Email *
Student Name *
Student's Date of Birth *
MM
/
DD
/
YYYY
Gender *
Student Email
Address *
Student Phone Number
Guardian #1 Name (First, Last) *
Guardian #1 Relation to Student *
Guardian #1's Email *
Guardian #1's Cell Number *
Guardian #2 Name (First, Last)
Guardian #2 Relation to Student
Clear selection
Guardian #2's Email
Guardian #2's Cell Number
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