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PARENTAL CONSENT FORM FOR MINORS UNDER 18 YEARS OLD

REQUIRED FOR MINOR COMING WITHOUT PARENT/LEGAL GUARDIAN

(MUST BE NOTARIZED TO BE A VALID DOCUMENT)

I/We, parent(s) or legal guardian(s) of,

TBD

Give permission for TBD, to sign any/all releases for my

child on my/our behalf for TBD, to enter General Sams Offroad Park,

on the following date(s) TBD to TBD.

I/We, parent(s) or legal guardian(s) of, TBD

Give permission for TBD, to make any medical decisions if

necessary for my child, TBD.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Third Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Fourth Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Fifth Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Sixth Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Seventh Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Eighth Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Ninth Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Tenth Participant's Name

First Name*

Middle Name

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

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

ANY KNOWN MEDICAIONS, ALLERGIES, CONDITIONS:
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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