Sunscreen Consent Form
Please complete this form to provide consent for sunscreen application.
Participant Full Name
*
First Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Participant
*
Please Select
Parent
Guardian
Other
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Does the participant have any known allergies or skin sensitivities?
*
No
Yes (please specify below)
If yes, please specify allergies or sensitivities
Type of sunscreen to be applied
*
Provided by organization
Provided by parent/guardian
Brand and SPF of sunscreen (if provided by parent/guardian)
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Signature of Parent/Guardian
*
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Consent
Submit Consent
Should be Empty: