Whitewater Rafting Parental Consent Form

Participant Information

Participant Name Date of Birth Address Phone Number

Parent/Guardian Information

Parent/Guardian Name Relationship to Participant Phone Number Email

Medical Information

Allergies or Medical Conditions Emergency Contact Name Emergency Contact Phone

Consent

I, the undersigned parent/guardian, give permission for my child to participate in the whitewater rafting activity. I acknowledge the risks and certify that the participant is medically able to participate.

Parent/Guardian Signature Date