Cobb County School District "Blanket" Permission To Participate Form/medical History Permission And Release Form/etc. Page 7

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NW Metro Atlanta Habitat for Humanity
Parental Permisison for Minor to Participate in Build
IMPORTANT: If the Volunteer is less than 18 years of age, all parents or guardians
must also sign this Release and Waiver of Liability with a witness. If only one parent
or guardian executes this Release on behalf of a Volunteer who is under 18 years of
age, then the undersigned parent or guardian of the Volunteer hereby covenants,
warrants, represents and agrees that he or she is executing this Release on behalf
of, and as an agent for, any other individual who may be a parent or guardian of the
Volunteer, and that by executing this Release, the undersigned is binding
himself/herself, the Volunteer, and any other parent or guardian of the Volunteer,
and all of their heirs, executors, personal representatives, assigns and estates to this
Release.
Parent/Guardian: Name (please print): _______________________ Signature: _________________________
Address: _________________________________________________________________________________________
Witness: Name (please print): __________________________________ Signature: ________________________
Parent/Guardian: Name (please print): ________________________ Signature: ________________________
Address: _________________________________________________________________________________________
Witness: Name (please print): ______________________________ Signature: ____________________________
IF APPLICABLE:
School/Organization (no abbreviations please):
Host Affiliate Site:
NOTE: Also, all parents or guardians must complete the “Parental Authorization for Treatment of, and
Travel With, a Minor Child” on the following page (ONLY if out-of-state or international travel is
involved).
Page 7 of 7
Waiver/Release Form v4.2014

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