parental consent form 2020

Parental Consent/Healthcare Surrogate Designation (specified person) 2020

 

I, _________________, parent of ___________________________ give

permission for _________________________ to sign any paperwork for

________________ to participate in MTF directed motocross training on the

following dates _______________________ at the following motocross

tracks ______________________________.

I, _____________________, also give permission for __________________

to make any medical decisions for _____________________ during those

dates.

Signed: __________________________________

Printed Name:_____________________________

EMERGENCY CONTACT PHONE NUMBERS:

Home: _____________ Cell: _______________ Other: ___________

THIS FORM MUST BE NOTARIZED