CONSENT FORM for PARENT/GUARDIAN

This consent shall be filled up by the parents of the girl child in order to take part in PKKK
online activity/meeting

Title of the challenge : PKKK Youth Advocates Assembly 2020 via zoom on November
28, 2020 at 9:00-12:00 NN
Youth Participants name : _________________
1. I confirmed that my child will join the online activity/meeting of PKKK and I understand
what is required of my child if they take part in this.
2. I have been given the opportunity consider the information, ask questions and reply was
given for all questions to my satisfaction.
3. I understand that participation is voluntary and that my child may withdraw at any time
without giving a reason.
4. I consent to any information given to my child being used in communication materials
related to the online activity/meeting
5. I understand that my child’s name will not appear in any communication material without
my consent.
6. I give permission for my child to take part in this online actovity/meeting

Name of parent/Guardian: ___________________________________________

Relationship to child: _______________________________________________

Signature/Thumbprint/verbal consent: __________________________________

Date :____________________________________________________________