EmailMe Form - 2015 YOUTH ROWING PARENT CONSENT FORM

1971

YOUTH

Details of youth seeking consent

Name of Youth Rower
(aged 14-18 yrs) *

First Last

Date of Birth *

MM / DD / YYYY

PARENT / GUARDIAN

Details of Parent / Guardian giving consent.

Name of Parent / Guardian giving consent to a
‘Responsible Individual’ *

First Last

Parent or Guardians Email *

Parent or Guardians Mobile Phone *

The parent or guardian will be contacted by the club on receipt of this form.

Parent / Guardians STATEMENT

I am aware of the hazards involved in coastal rowing and give my consent to this named individual to supervise my child during these activities.
In so doing I am assured that they are;
Competent and knowledgeable in sea safety
Provide sufficient safety equipment
Will behave appropriately in the company of youths

Parent / Guardians *

My Consent

Parents Signature

Clear

Use the mouse and left click to 'draw' your signature.