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Activity: Youth Gym Nights At Brampton Christian School

Date of Activity: Duration of 2023 (future dates to be determined)

*** PLEASE NOTE: THIS IS A BLANKET CONSENT FORM FOR ALL JR HIGH GYM NIGHTS FOR THE REMAINDER OF 2023.***

Details of the Activity: Jr High Students are invited to GYM NIGHTS at Brampton Christian School (12480 Hutchinson Farm Ln, Caledon, ON).

The night will generally run from 7pm - 9pm and include sports such as basketball, volleyball, games and other physical activities.

Parents/Guardians to drop off & pick up student(s) at Brampton Christian School


Dear Parent:

We are planning an activity as part of our programming that requires your permission prior to participation. We have provided you the details of the activity and request that you complete and sign the permission form. The safety of your child is our primary concern. Precautions will be taken for their well being and protection.
















Participant
Minor
Continue
First Participant Name

First Name*

Last Name*

Phone*
First Participant Date of Birth*
First Participant Information

Health Card Number *

Doctor's Name & Phone Number *
Does the participant have any allergies?*
No
Yes
Will the participant be bringing medication with them?*
No
Yes
Photo/Video Consent *
Internal Use Only
External Use Only
Both Internal & External Use.
First Participant Signature*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent or Guardian Email Address

Email*

Confirm Email*
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 Name

First Name*

Last Name*

Phone*
Parent or Guardian Date of Birth*
Parent or Guardian Information

Health Card Number *

Doctor's Name & Phone Number *
Does the participant have any allergies?*
No
Yes
Will the participant be bringing medication with them?*
No
Yes
Photo/Video Consent *
Internal Use Only
External Use Only
Both Internal & External Use.
Parent or Guardian 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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