Parent/guardian permission form - WISE

Wholly Informed Sex Ed

Parent/guardian permission form

Parents/Guardians, please fill out this form after you have registered your child/children.

For child’s participation in our whole lives sexuality education for grades:

Please check one

4-6

7-9

10-12

We/I give permission for this child or children to participate in Our Whole Lives: Sexuality Education part of the education program at Camp WISE.

Please list the child's or childrens's names and their grades:

I/We have been offered the opportunity to view program materials.

Yes

No

I/We have been offered the opportunity to attend an orientation to this program.

Yes

No

I/We have opted not to attend an orientation to this program.

Yes

No

Parent/Guardian: please sign form

Parent/Guardian 1

Please enter information below

Name

Address

Home Phone

Work Phone

Cell Phone

Email

Date signed

Parent/Guardian 2

Please enter information below

Name

Address

Home Phone

Work Phone

Cell Phone

Email

Date Signed