Parental Waiver for Children age 15

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Parental Waiver for Children age 15 - 17

I hereby state that I am the parent or legal guardian of a minor child age 15 -17. 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

Child's Name

Mailing Address

Phone Number

Phone information will be kept confidential, and will be used only if we need to contactyou regarding your child.

Alternate Phone

By typing your name here you acknowledge that you are making an electronic signature to affirm this document.

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