Minor Participant Outbound Trip Authorization Form
Participant Information
Full Name
Date of Birth
Address
Parent/Guardian Name
Parent/Guardian Phone
Trip Information
Destination
Departure Date
Return Date
Purpose of Trip
Emergency Contact
Contact Name
Phone Number
Relationship to Participant
Authorization
I, the undersigned parent/guardian, authorize the above-named minor to participate in the described outbound trip.
Parent/Guardian Signature
Date