Adventurer Club Activities Parental Consent Form

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Email *

After reading below, please indicate your child's full name if under 18 years old: *

After reading below, please indicate the name of the event/activity your child will be attending: *

What is the date of the activity mentioned above? (YYYY/MM/DD) *

Where is the activity located? *

Please confirm that you have read, understood and agree to the statement below by typing your name. *

In addition, permission is hereby given for any photos, videos or other media format of my child to appear in any advertising or reporting material produced by the Ontario Conference or its parent organizations. *

Yes

Other:

By typing my name below, I the Parent/Guardian of the aforementioned Adventurer, certify that the above information is accurate as far as I know, and the person herein described has permission to engage in all prescribed activities, except as noted by me. *

I am: *

Mother

Father

Legal Guardian

Other:

Date (YYYY/MM/DD) *

By typing my name below, I the Parent/Guardian #2 of the aforementioned Adventurer, certify that the above information is accurate as far as I know, and the person herein described has permission to engage in all prescribed activities, except as noted by me.

I am:

Mother

Father

Legal Guardian

Other:

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Date (YYYY/MM/DD)

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