Child Authorization
When your child is in an activity with a school or other organization, you will usually be asked to sign an authorization. Less formal groups may not have a form, and the form used by your group may not cover all of the conditions you wish to impose upon the activity. For these instances, a CHILD AUTHORIZATION form can be used.

Sample Child Authorisation

To: _____________________________________________
This is to confirm that my child, __________________________________________, is authorized to participate in: ___________________________________________________________ on _______________________, 20_____ under the following conditions:

If these conditions will not be met, my child may not participate.

During participation, I can be reached at:

Cell phone:____________________________________________________
Beeper: _______________________________________________________
Other phone:__________________________________________________
Other phone:__________________________________________________

If I cannot be reached in any of these ways, I authorize _________________________________________ to consent to any emergency medical care that may be necessary.


Accepted by: