Extracurricular Club Parent Consent Form
Student Information
Student Name
Grade
Club Name
Parent/Guardian Information
Parent/Guardian Name
Phone Number
Email Address
Medical Information
Relevant Medical Conditions (if any)
Consent
I give permission for my child to participate in the above club and its related activities.
In case of emergency, I authorize the club staff to seek necessary medical attention for my child.
Parent/Guardian Signature
Date