MINOR AUTHORIZATION FORM – Tall Pines ATV Park

First Name

Last Name

Email

Telephone

How many minors will you be allowing someone else to bring?

Do these minors all belong to the same parent/guardian?

Yes

No

Paragraph

THE PARENT OR LEGAL GUARDIAN NEEDS TO COMPLETE THIS FORM FOR ALL MINORS BELONGING TO THE SAME PARENT/GUARDIAN. THEN THE PARENT OR LEGAL GUARDIAN, NOT THE PERSON BRINGING THEM, MUST FILL OUT A MINOR WAIVER FOR EACH CHILD. THIS CAN BE DONE ONLINE AT: TALLPINESATVPARK.COM.   SELECT "MINOR WAIVER" AND FILL IT OUT COMPLETELY. MAKE SURE YOU TAKE A PICTURE OF YOUR DRIVERS LICENSE OR PICTURE ID. YOU CAN ADD UP TO 5 MINORS ON THIS WAIVER.  TO COMPLETE THIS PROCESS, CHECK YOUR EMAIL AND CLICK ON "VERIFY EMAIL" TO FINISH AND VALIDATE THE WAIVER.

MORE THAN 5 MINORS - YOU NEED TO CALL US OR FILL OUT THIS FORM FOR THE FIRST 5 AND FILL OUT THE FORM AGAIN FOR THE REMAINING.

MINOR 1

First Name

Last Name

Relationship

Parent

Court Appointed Guardian

MINOR 2

First Name

Last Name

Relationship

Parent

Court Appointed Guardian

MINOR 3

First Name

Last Name

Relationship

Parent

Court Appointed Guardian

MINOR 4

First Name

Last Name

Relationship

Parent

Court Appointed Guardian

MINOR 5

First Name

Last Name

Relationship

Parent

Court Appointed Guardian

Tall Pines Staff ONLY

Please select all that apply

Verify Note from Parent

Verify Parents Signature on License Matches Note

Verify Parents Filled Out the Waiver

Verify Parents Signature on License Matches Waiver

Asked if Minor has permission to ride here

Explained that this is a dangerous activity

Secured verbal permission to consent for medical treatment

Secured verbal permission to consent for medical transportation

Who's phone did you use?

My Cell

Tall Pines Phone

DO NOT DELETE YOUR CALL HISTORY!!!

Who completed this form - FULL NAME

Disclaimer

I hereby acknowledge all statements to be true and correct to the best of my knowledge

Signature

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