Parental Consent Form 2004

Date __________________

Attn: Rochester Pagan Pride Day coordinators

I hereby give permission for _____________________________ to participate in the planning or workshops and events of the Rochester Pagan Pride Festival. I hereby state that I am said minor's parent or guardian.

For any emergency situations please contact me at ________________.

Sincerely, Sign __________________________________ Date ______________________

Please print name ____________________________________

©Celestial Web