Boston Public Library Standard Release Form Henna Tattoos
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1Boston
P ublic
L ibrary
Standard
R elease
F orm
Henna
T attoos
I
h ereby
g ive
m y
c onsent
f or
t he
u ndersigned
m inor
c hildren
t o
r eceive
a
f ree
henna
t attoo.
I
a ttest
t hat
I
a m
t he
p arent
o r
l egal
g uardian
o f
t he
c hildren
l isted
below.
Name:
_ ____________________________________________________________
Signature:
_ _________________________________
D ate:
_ __________________
Email:
_ ____________________________________________________________
Names
a nd
A ges
o f
M inor
( under
1 8)
C hildren:
Name:
_ _____________________________________
A ge:
_ ____
Name:
_ _____________________________________
A ge:
_ ____
Name:
_ _____________________________________
A ge:
_ ____
Name:
_ _____________________________________
A ge:
_ ____
Name:
_ _____________________________________
A ge:
_ ____
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