BGCTC School Release Form

Child's Name *

First

Last

Child Educator / Administrator *

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Phone *

Emergency Contact Number *

I hereby consent to participation by the child named above in the BGCTC event and give permission for them to be released from the class. I understand that this event will take place away from school grounds and that my child will be under the supervision of the BGCTC staff. I further consent to the conditions of participation in this event, including the method of transportation.

Parental Consent for Child *