I certify that I am the guardian of the following child/ren.  By completing this form below, I hereby give permission for my child/ren to attend various field trips at the discretion of the staff at The Children's House at Serenbe.  I understand that my child will walk or ride in a vehicle driven by a parent who has completed the Parent Volunteer Driver form and has met all the requirements set by The Children's House at Serenbe.

Name of child / children *
Name of child / children
Parent Daytime phone number
Parent Daytime phone number
Does your child carry an epipen? *