Student Registration and Permission Slip
This is a permission and consent form for the below named student to attend "Vape Escape: Plant and Paint" at the Bryant Neighborhood Center (1619 6th Ave., Tacoma, WA  98405) on Friday, March 28th, 2025 from 3:30-5:30. 
Sign in to Google to save your progress. Learn more
Student Name *
Preferred Pronouns *
Parent / Guardian
First and Last Name 
 *
Relationship *
Phone Number  *
Email *
Emergency Contact  *
Relationship *
Mobile Phone *
In the event of an emergency involving the student listed above, I understand that every effort will be made to contact a guardian or emergency contact listed above. If no one can be reached in a timely manner, I give permission for the Bryant Neighborhood Center staff to seek, authorize, and consent to such medical care for the student as deemed necessary or appropriate by medical professionals. I give permission to those administering emergency treatment to do so, using measures deemed necessary. I absolve the Bryant Neighborhood Center and its staff from liability in acting on my behalf in this regard. *

I give the Bryant Neighborhood Center permission to use photographs and/or video recordings internally and externally to promote the BNC Partners and events.

 *
I understand and agree that by typing my name below I am providing a binding electronic signature verifying the above information. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Trinity Presbyterian.

Does this form look suspicious? Report

Google Forms