Parental Consent Form for Community Swim Meet

Participant Information

Child’s Full Name Address Emergency Contact Name Emergency Contact Phone Relationship to Participant

Medical Information

Allergies / Medical Conditions Current Medications Family Physician Name Family Physician Phone

Consent & Acknowledgements

I, the undersigned parent/guardian, hereby give consent for my child to participate in the Community Swim Meet. In the event of an emergency, I authorize the organizers to obtain any necessary medical treatment for my child. Signature of Parent/Guardian Date