Parental Waiver for Children age 0-14

I hereby state that I am the parent or legal guardian of a minor child age 0-14. My child has my permission to attend the OryCon 41 Convention, November 8th - 10th, 2019, in Portland, Oregon. I acknowledge that Oregon Science Fiction Conventions Inc, OryCon41, and its organizers accept no responsibility for supervising my child, and I make no special request for any special notice or supervision of my child on the convention premises,or arriving at or departing from the convention.I have read the OryCon41 Code of Conduct, and acknowledge my responsibility for my child’s behavior.

Parent Name
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Child's Name
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Mailing Address
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Phone Number
Phone information will be kept confidential, and will be used only if we need to contactyou regarding your child.
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Alternate Phone
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By typing your name here you acknowledge that you are making an electronic signature to affirm this document.
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