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Rising Sons Initiative Parental Consent Form

Empowering the Sons of Single Mothers to Reach Their Full Potential

Participant's Information

Date of Birth
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Mother's/Guardian's Information

Emergency Contact Information

Parental Consent and Agreement

I, the undersigned, am the parent/legal guardian of the above-named participant. I hereby give my full consent and permission for my son to participate in the Rising Sons Initiative. I understand that this program involves a variety of activities, including physical exercises, workshops, mentorship sessions, and field trips.


Consent for Participation:

I consent to my son participating in all scheduled activities and events of the Rising Sons Initiative. I acknowledge that the program will provide a safe and supportive environment for my son and that all necessary precautions will be taken to ensure his well-being.


Medical Consent:

I authorize the program staff to obtain any necessary medical treatment for my son in case of an emergency. I understand that reasonable efforts will be made to contact me in such an event.


Liability Release:

I release and hold harmless The Umbrella Inc., its staff, volunteers, and partners from any and all liability, claims, or demands arising from or in connection with my son's participation in the program. This includes any personal injury, property damage, or loss that may occur.


Media Consent:

I grant permission for my son's image, likeness, and voice to be used in promotional materials, including photographs, videos, and other media related to the Rising Sons Initiative. I understand that these materials may be used for marketing and informational purposes.


Additional Information:

I confirm that I have provided accurate information regarding any medical conditions, allergies, or specific concerns related to my son. I understand that this information is crucial for the program staff to adequately support and accommodate my son's needs.

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