Back to Templates
Minor Participation Waiver
Parent or guardian consent and release for a child to take part in an activity
waivers · 12 fieldsChild's Full Name*
Enter child's full name...
Child's Date of Birth*
mm/dd/yyyy
Parent or Guardian Name*
Enter parent or guardian name...
Relationship to Child*
Select an option
Parent Email*
Enter parent email...
Parent Phone*
Enter parent phone...
Activity or Program*
Enter activity or program...
Child's Allergies or Medical Conditions
Type your answer...
Emergency Contact (Name & Phone)*
Enter emergency contact (name & phone)...
Medical Authorization*
I authorize emergency medical treatment for my child if I cannot be reached
Release of Liability*
On behalf of my child, I release the organizer from liability for injury
Parent or Guardian Signature*
Sign here