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.
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.
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: