Parent Permission Form

Participant's Name*

Participant's Gender*

Participant's Age*

Mother's Name*

Enter first and last name

Address*

Enter Street Address, City, State, Zip Code

Mother's Cell/Home Phone Number*

Mother's Email Address*

Father's Name*

Enter first and last name

Is the home address the same as previous?*

YesNo

If no, please enter Father's Address

Enter Street Address, City, State, Zip Code

Father's Cell/Home Phone Number*

Father's Email Address

I affirm that I am the natural parent (or legal guardian) of*

Enter participants name(s)

AND I give my consent to said minor child’s participation in all College Bound Florida activities. the undersigned does assume all risks and hazards involved to participate in this activity and releases College Bound Florida from all liability from negligence; action or inaction by College Bound Florida, its staff, volunteers, or agents; and action or inaction by volunteers and agents of any co-sponsoring agency for any injury and loss or damage connected in any way whatsoever to participate in college Bound Florida activities whether on or off premises. The undersigned acknowledges that participation in College Bound Florida activities may involve risks of contact between the participants, parents, guardians, or agents.*

YesNo

By entering my name , I understand this entry will be considered an electronic signature of my agreement and acknowledgment of the above consent for participations*

Enter full legal first and last name

Today's Date*

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