How to Write
Step 1 – Download in PDF.
Step 2 – The top section of the consent form must include the following information, completed by the parent/guardian:
- Participant’s/child’s name and birth date
- Parent’s/guardian’s name
- Parent’s/guardian’s address
- Parent’s/guardian’s phone number(s)
- Parent’s/guardian’s email address
Step 3 – Next, the parent/guardian must print their name, their child’s name, and the name of the organizer in the first paragraph of the form.
Step 4 – The organizer must enter the following information into the spaces provided on the first page of the form:
- Type of event
- Event location
- Individual(s) in charge
- Date and time of departure and return
- Mode of transportation(s) involved
Step 5 – The parent/guardian must include a signature and the date at the bottom of page 1.
Step 6 – Proceed to the “Emergency Medical Treatment” section on page 2. In case they cannot be reached, the parent/guardian should provide the name, relationship, and phone number of an emergency contact. The name and phone number of the child’s family doctor can be entered below the emergency contact information, as well as the family health plan carrier and policy number.
Step 7 – The following medical information/conditions should be shared with the organizers under the “Specific Medical Information” section:
- Allergies
- Date of last immunizations
- Medically relevant diet information
- Physical limitations
- Specific conditions
- Exposure to contagious diseases
- List special medical conditions
