Application 11

Youth Participant / Parent Permission Form

Request youth participation in an Heritage & Opportunity Alliance program. Heritage & Opportunity Alliance will verify permissions before participation.

Parents and guardians enrolling youth in Heritage & Opportunity Alliance activities← All applications

Private youth information

This submission is stored privately for Heritage & Opportunity Alliance review. Do not include Social Security numbers, insurance numbers, or unnecessary medical records.

Parent or guardian full name * Parent or guardian email * Parent or guardian phone * Youth name * Age, school, and grade * Program or activity of interest * Accessibility, allergy, medical, or special-support information Heritage & Opportunity Alliance should privately follow up about Emergency contact name and phone * Participation, photo/video, and transportation permissions or limitations * I certify that the information provided is accurate. I understand that submitting this form does not guarantee appointment, payment, partnership, membership, vendor approval, employment, or program participation.I authorize Heritage & Opportunity Alliance to contact me about this application.