Permission Form

Please fill out the following information for your child(ren) to participate in our event. A new form will need to be filled out for each child separately. Thanks!

Children’s Permission/Medical Form

"*" indicates required fields

Child's Name*
MM slash DD slash YYYY
Physical Address if Different from Mailing Address
Mother's Name*
Father's Name*
Emergency Contact*
My Child Does NOT Have Insurance
Include special medical needs or concerns such as asthma, allergies, conditions, dietary needs, medications, etc.
This field is for validation purposes and should be left unchanged.