Community Service Site Visit Consent Form

Participant Information

Full Name: Date of Birth: Email Address: Phone Number: Address:

Site Visit Details

Organization Name: Site Visit Date: Site Address:

Consent

I acknowledge that I have been informed about the nature and purpose of the community service site visit. I understand the activities and any associated risks. I consent to participate and will comply with the safety guidelines provided by the organizers.

I give my consent to participate in the site visit.

Emergency Contact

Name: Relationship: Phone Number:

Signature: Date:

Parent/Guardian Signature (if under 18): Date: