Parental Consent Form

Agreement

I, the parent and/or legal guardian (Guardian) of the volunteer who is under the age of 18 (Minor Volunteer). As Guardian, I affirm that I have been completely informed all the volunteer activities that the Minor Volunteer will participate. I understand the general structure of the volunteer activities and do not need to be informed of each and every activity.

Guardian Name *

Guardian Phone *

Guardian Email *

Guardian Address *

Country

City

State

Zip code

Minor Volunteer Name *

Minor Volunteer Phone *

Minor Volunteer Email *

Minor Volunteer Birthdate *

The Minor Volunteer currently has the following conditions/diseases which Souderton Connects should be aware of:

I hereby give this consent during the calendar dates of:

Starting Consent Date *

Ending Consent Date *

Signature *

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