Member Consent Form
_____________________________ has my permission to be responsible for my child(ren)
___________________, ___________________, ___________________,
___________________, ___________________, ___________________
at this TACHE event.
In case of medical emergency they are authorized to seek medical attention for my child(ren).
Parent signature / Date / Phone number
Heath Insurance Information:
Company: _________________________________
Policy: # __________________________________
Doctor: ____________________________________
Preferred Hospital: ____________________________