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Parent/Guardian Agreement

As a Great Plains MakerSpace member or guest and the parent/guardian of one or more children of 15 years old or younger, I agree to maintain adequate supervision of my children any time they are in the makerspace or on the grounds. “Adequate supervision” means I will stay in visual contact with my children any time they are outside the designated Children’s Lab. Additional “adequate supervision” guidelines may be posted at the entrances to individual labs. When my children are in the Children’s Lab, I agree to check in with them at least every 15 minutes, and I agree to respond in a timely manner to disruptive behavior on the part of my children.

I acknowledge that continued disruptive behavior on the part of my child may result in me being asked to leave. Further, I acknowledge that I will be financially liable for any damage my children cause while in the makerspace or on the grounds.

Today's date: July 24, 2021

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 17 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 17 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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