Community Garden Child Participant Form
Participant Information
Child's Full Name
Date of Birth
Address
School Name
Grade
Parent / Guardian Information
Parent/Guardian Name
Phone Number
Email
Emergency Contact
Emergency Contact Name
Emergency Phone
Medical Information
Any Allergies or Medical Conditions?
Medications Needed
Permissions
I give permission for my child to be photographed at the community garden.
I give permission for my child to participate in all garden activities.
Signature
Parent/Guardian Signature
Date