Parental Consent

Minors Name:____________________________________________________________
Minors Address:____________________________________________________________
____________________________________________________________
____________________________________________________________
 
Name of attending adult: ______________________________________

I ___________________________ give my authorization and consent, and warrant that I have the legal authority as the minor's parent or legal guardian to grant such consent, for the above-named minor to attend the Sakura-Con 2014 convention ("Convention"). I understand that the Convention staff, organizer's, employees and/or agents, etc, have no responsibility whatsoever to monitor or supervise the minor at any time during the Convention, and I agree to hold Sakura-Con, ANCEA , its Board of Directors, organizer's, employees and/or agents, etc, harmless of any wrong doing, claims, demands or liability. I further accept financial responsibility and agree to fully indemnify Convention for any damages caused by my child, whether caused by his/her willful conduct or negligence, at any time during his/her attendance at the Convention.

Parent/Legal-Guardian Signature:___________________________

Printed Name:___________________________

Parent/Legal-Guardian Contact Phone Number:___________________________

Date:___________________________