PARTICIPANT PARENT/GUARDIAN PERMISSION FORM
My son/daughter has permission to participate in the Luv2Run
program at his/her school. I give permission for the Luv2Run organizers to
administer first aid treatment and/or allow a physician or hospital to
administer treatment to my child in case of emergency. I waive and release any
and all rights, claims, and causes of action I have or may have against my
child’s school and Green Bay Marathon, Inc. that may arise as result of my
child’s participation in the Luv2Run training program and the Cellcom 5K Run.
Participant Information:
Child’s Name
_____________________________ Grade ____ Teacher_______________
Child’s Name
_____________________________ Grade ____ Teacher_______________
Child’s Name
_____________________________ Grade ____ Teacher_______________
Contact Information:
_________________________________________________________________________
Parent Name(s)
________________________________________________________________________
Address
Address
___________________________________ __________________________________
Primary Phone Number Secondary Phone Number
Primary Phone Number Secondary Phone Number
_______________________________________________________________________
Email Address
*Please be sure
to include your email address. Schedule changes and important updates will be
communicated via email.
___________________________________ __________________________________
Emergency Contact
Name
Phone
_____I would love to help or be a parent
volunteer!
____________________________________________________ _________________
Parent or Guardian Signature Date
