Skip Navigation Links
Home
Register Now
Accommodations
View Room Options
Map, Parking and more
Rider Reunions Tips
Who's Coming to Reunions?
Give to Rider

 

 

 

 

CONSENT FOR CHILD CARE


I intend to be an attendee at the Rider University Reunion on June 8, 2013 and I am the parent of a minor child or children.  By signing this consent form I confirm that I have agreed to have my child or children named below to be placed in the care of Rider University during the day of June 8, 2013, which care will be provided by students of Rider University.


This is also my consent to Rider to authorize emergency medical treatment if it appears to be necessary and Rider cannot locate me in time to make the medical decision.

 

The name and age all each of my children subject to this consent are as follows:

 

 

Name (please print)______________________________________________ Age _____

 

Name (please print)______________________________________________ Age _____

 

Name (please print)______________________________________________ Age _____

 

 

Name of Parent (Please print)_______________________________________________

 

Signature of Parent_______________________________________________________

 

My cell phone number is (please print clearly)___________________________________

 

I am requesting childcare during the hours of________________ and ________________