Job Shadow Consent Form For Minors

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Job Shadow Consent Form for Minors
I understand that my child, ___________________________________________, (a minor) is participating in a
Job Shadow experience at Ranken Jordan Pediatric Bridge Hospital. I also understand that my child has
requirements/responsibilities within this program, of which he/she is aware, and that failure to comply with
these requirements/responsibilities may result in dismissal from this experience.
NOTE: This form must be signed by the parent/guardian and brought to the Human Resources Department
before the day of shadow experience. The minor will not be permitted to participate in the noted program if
they fail to bring with them.
__________________________________________
________________________
Job Shadow Participant Signature
Date
__________________________________________
________________________
Parent/Guardian Signature
Date
__________________________________________
________________________
Human Resources Representative
Date
IF YOU ARE UNDER THE AGE OF 18, PLEASE HAVE YOUR PARENT OR LEGAL GUARDIAN COMPLETE THIS FORM.

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