Athlete Parental Consent Exit Interview Form

Athlete Information

Athlete Name Date of Birth Sport Team/Club

Parent/Guardian Information

Parent/Guardian Name Relationship to Athlete Contact Number Email

Exit Interview Questions

Reason for Leaving the Team/Program Describe your and your athlete's experience with the team/program Were there any concerns or issues you encountered? Suggestions for Program Improvement

Parental Consent

I confirm that I have read and understood the above exit questionnaire and provide my consent. Yes No Parent/Guardian Signature Date