Parental Consent Form for Child’s Medical Treatment During Events
Child Information
Full Name
Date of Birth
Address
Parent/Guardian Information
Full Name
Relationship to Child
Phone Number
Email Address
Medical Information
Allergies/Medical Conditions
Medications
Doctor’s Name and Contact
Health Insurance Provider & Policy Number
Consent
I give permission for my child to receive emergency medical treatment during the event(s).
Additional Notes or Instructions
Parent/Guardian Signature
Date