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  • CBD 2010 Guardian Consent Form

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    Lijin Chen
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    Guardian consents to child's participation in the Chinatown Beautification Day. By signing below, I certify that I have read and agree to be bound by the above in its entirety. In the event of a medical emergency, I authorize my child's advisor or counselor to oversee medical treatment.

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    Guardian consents to child's participation in the Chinatown Beautification Day. By signing below, I certify that I have read and agree to be bound by the above in its entirety. In the event of a medical emergency, I authorize my child's advisor or counselor to oversee medical treatment.

    Copyright:

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    652 views1 page

    CBD 2010 Guardian Consent Form

    Uploaded by

    Lijin Chen
    Guardian consents to child's participation in the Chinatown Beautification Day. By signing below, I certify that I have read and agree to be bound by the above in its entirety. In the event of a medical emergency, I authorize my child's advisor or counselor to oversee medical treatment.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    Chinatown Beautification Day

    Guardian Consent Form for 2010 Citywide Youth Conference

    I, ___________________________, the legal parent or guardian of the student named below, do


    hereby give permission for my child to participate in the Chinatown Beautification Day (CBD) on
    Saturday, August 14th, 2010 and on Sunday, August 15th, 2010. As a condition of my child’s participation,
    I hereby discharge the Chinatown Youth Initiatives, and its officers, agents, volunteers, and employees
    from all legal liability stemming from my child’s participation in CBD, including injury, death, and
    property damage of any description.

    I also agree to assume responsibility, both legal and financial, for any actions taken by my child during
    the period of his/her participation in CBD.

    I hereby grant permission for my child to participate fully in CBD activities. Also, I give me permission
    for any agent, officer, volunteer, or employee of the Chinatown Youth Initiatives to transport my child to
    a doctor or hospital in the event of a medical emergency. I authorize my child’s advisor or counselor to
    oversee medical treatment, including by not limited to emergency surgery or medical treatment, and I
    assume the responsibility for all medical bills that may result from such services.

    Further, should it become necessary for the participant to return home due to medical reasons,
    disciplinary action or for any other reason, I will assume all transportation costs.

    By signing below, I certify that I have read and agree to be bound by the above in its entirety.

    Name of Participant (Print): _________________________________________________

    School of Participant (Print): _________________________________________________

    Name of Parent/Guardian (Print): ____________________________________________

    Signature of Parent/Guardian: _______________________________________________

    In the event of an emergency, I can be reached at this phone number: _________________

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