parental consent form – Omega Psi Phi Fraternity, Inc.

Well Prepared Program - Parental Consent Form

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The Parental Consent Form is a form that parents or legal guardians of children must sign in order to allow children to participate in activities hosted by Omega Psi Phi Fraternity, Inc. All minor, youth and guests must have a signed form to participate in any activities under the guise of Omega Psi Phi Fraternity, Inc. It is recommended that parents/legal guardians keep a copy of the form and contact the activity leader in the event of any questions or in case emergency contact is needed.
Participation Information
Child(ren)*
First Name Middle Initial Last Name Gender Birthdate (mm/dd/yy) Age During Activity

Enter information for each child (Click on "+" to add child)
Address*
Street Address Apartment/Unit # City State ZIP Code
My child has permission to participate in*

Name of Activity
My child has permission to participate with the chapter*
HOLD HARMLESS AGREEMENT

I understand that participation in the activity involves a certain degree of risk. I have carefully considered the risk involved and have given consent for myself or my child to participate in the activity. I understand that participation in the activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release Omega Psi Phi Fraternity, Inc., the chapter, the activity coordinators, and all volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of the participation.
Parent/guardian name
First Last
Parent/guardian signature
Phone (Work)
Phone (Cell)*
Email*

First Name	Middle Initial	Last Name	Gender	Birthdate (mm/dd/yy)	Age During Activity

Well Prepared Program - Parental Consent Form

Participation Information