School Activity Parent/Guardian Consent Form
Student Information
Student Name
Grade/Class
Teacher
Activity Information
Activity Name
Date(s) of Activity
Location
Additional Details
Medical Information
Allergies or Medical Conditions
Emergency Contact Name
Emergency Contact Phone
Doctor's Name
Doctor's Phone
Consent
I give permission for my child to participate in this activity.
I authorize emergency medical treatment if necessary.
Parent/Guardian Name
Signature
Date