Consent Form

By Parents or Guardians
________________________________________________________________
First name of Child, middle initial Last name
________________________________________________________________
Additional children, First name Age Last name
________________________________________________________________
First name Age Last name
________________________________________________________________
First name Age Last name
________________________________________________________________
Address Age Birth Date
_______________________________________________________________
City State Zip
_________________________________________________________________
Telephone number– cell Telephone number-
home
Approval
(If two parents/guardians, both need to sign)

__________________________________________________________________
For (name of event) ON
(dates)
___________________________________________________________________
Father/Guardian signature Date
___________________________________________________________________
Mother/Guardian signature Date
 PAGE 2
CHURCH OF THE WORD, SOUTH BAY
FOR OUR GUESTS UNDER 21 YEARS OF AGE, PARTICIPATING IN THE FASHION SHOW
PAGE 2
Please indicate with a check mark which category that
your child/children will be participating in
~Sign up Form~

Boys Girls

RED CARPET FORMAL ATTIRE

DIVA WEAR/GIRSL

FLY WEAR/BOYS

JUS CHURCHN WEAR

70S ATTIRE

80S ATTIRE

90S ATTIRE

CHURCH OF THE WORD, SOUTH BAY

FOR OUR GUESTS UNDER 21 YEARS OF AGE, PARTICIPATING IN THE FASHION SHOW