Child School Attendance Consent Form
Please provide the following information and consent for your child's attendance at school.
Student's Full Name
*
First Name
Last Name
Student's Date of Birth
*
-
Month
-
Day
Year
Date
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Student
*
Please Select
Mother
Father
Legal Guardian
Other
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
School Name
*
Grade/Class
*
Attendance Period (Start Date)
*
-
Month
-
Day
Year
Date
Attendance Period (End Date)
*
-
Month
-
Day
Year
Date
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Notes or Instructions
Parent/Guardian Signature
*
Submit Consent
Submit Consent
Should be Empty: