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Minors Covid Waiver -Form Fill

Section One
Q1

In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following:
Q2

Following the pronouncements above I hereby declare the following:
Q3

Name of Volunteer

First Name
Q4

Name of Volunteer

Last Name
Q5

Name of Parent or Legal Gardian

First Name
Q6

Name of Parent or Legal Gardian

Last Name
Q7

Phone Number of Volunteer
Q8

Phone Number of Parent or Legal Gardian
Q9

Signature of Volunteer
Q10

Date Signed

Date
Q11

Signature of Parent or Legal Gardian