Participation of Minors - Student Organization Events

This form is for the legal parent/guardian to complete for individuals, under the age of 18, that are participants in a student organization sponsored event/program taking place on the West Chester University campus.   



This form is required for ALL parent/guardians to complete in order to provide consent and emergency contact information.

Participation of Minors - Student Organization Events

This form is for the legal parent/guardian to complete for individuals, under the age of 18, that are participants in a student organization sponsored event/program taking place on the West Chester University campus.

This form is required for ALL parent/guardians to complete in order to provide consent and emergency contact information.
Legal Parent/Guardian First Name: *


Legal Parent/Guardian Last Name: *


Legal Parent/Guardian Email address: *


Legal Parent/Guardian Phone Number: *


Emergency Contact Name *


Emergency Contact Email *


Emergency Contact Phone Number: *


I hereby certify that i am the minor participant's parent or legal guardian and I consent for their participation in this student organization event at West Chester University: *


First Name of Participating minor: *


Last Name of Participating Minor: *


Email of of Participating Minor: *


Phone Number of Participating Minor: *


Name of student organization sponsoring the event/program: *


Name of the event/program: *


Date of the student organization event/program:: *