CampusGroups

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

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: *

yes

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:: *