Workplace Child Visitor Consent Form
Please complete this form to provide consent and important information for your child’s visit to our workplace.
Child Visitor's Full Name
*
First Name
Last Name
Child's Age
*
Parent or Guardian Full Name
*
First Name
Last Name
Parent or Guardian Email Address
*
example@example.com
Parent or Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Visit
*
-
Month
-
Day
Year
Date
Time of Visit
*
Hour Minutes
AM
PM
AM/PM Option
Purpose of Visit
*
Please Select
Tour of the workplace
Meeting with parent/guardian
Participation in workplace event
Other
Employee Host Name (if applicable)
First Name
Last Name
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does the child have any allergies or medical conditions? If yes, please specify.
Are there any special instructions or needs for your child during the visit?
Parent or Guardian Signature
*
Submit Consent
Submit Consent
Should be Empty: