Extracurricular Activities Consent Form
Please fill out this form to give consent for your child to participate in extracurricular activities.
Child's Full Name
First Name
Last Name
Parent/Guardian's Full Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
List of Activities to Participate
Sports
Music
Art
Drama
Science Club
Debate Club
Other
Any medical conditions or allergies we should be aware of?
Parent/Guardian Signature
Submit
Should be Empty: