2023-2024 Guardian Consent Form

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2022 - 2023 Guardian Consent Form

Thank you for entrusting your youth student with us. Please fill out the following information. This information is to help ALC-YTH, keep in touch with parents/guardians about upcoming youth events, changes and /or cancellations. We need to have all information in case of emergencies. This form also gives us consent to drive your student for events, outings or rides home. Please keep us updated with any information changes.

Please Provide Guardian Email Below

Email *

Student Name *

Student's Date Of Birth *

YYYY

Gender at birth *

Female

Male

Student Email

Primary Home Address *

Student Phone number

Guardian #1 Name (First, Last) *

Relation to Student *

Guardian #1's Email *

Guardian #1 Cell Number *

Guardian #2 Name (First, Last)

Relation to Student

Guardian #2 Email

Guardian #2 Cell Number

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