Wildlife Education Program Permission Slip

Child's Name *

First Name

Last Name

Child's Date of Birth *

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Parent/Guardian Name *

First Name

Last Name

Emergency Contact Phone *

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Does your child have allergies to any of the following?

Corn Starch

Flour

Latex Gloves

Nitrile Gloves

Vinyl Gloves

Other

Reptile Interaction: During the program, children may have the opportunity to touch a reptile under supervision. *

Yes, my child may touch a reptile.

No, my child may NOT touch a reptile.

Use of Tools: Children may have the opportunity to work with non-sharp medical instruments and child-safe scissors as part of hands-on activities. *

Yes, my child may use these tools under supervision.

No, my child may NOT use these tools.

Photography Consent: We may take photos during the program for educational and promotional purposes. *

Yes, my child may be photographed.

No, my child may NOT be photographed.

Educational Content: As part of the program, we will be simulating animal rescue situations. This may include images of injured animals to help teach children about wildlife rehabilitation. *

I understand that my child may see images of animal injuries (age appropriate) as part of the learning experience.

Date Signed *

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DD

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