Terror in the Dark Haunted House
****************2017 Authorization for Minor Child Participation******************
(Every volunteer YOUNGER than 18 needs to complete this authorization  in order to participate)

I, (please print)________________________________________, hereby give authorization for my child
                                               (Parent/Guardian)

________________________________________ , to participate in all phases of implementation of the
                 (Minor's Name)

Terror In The Dark Haunted House for October and/or November.  I understand that the house will be in
operation in October, with tear-down the first few days in November.

______________________________                _________________       ______________________
Parent/Guardian Signature                                 Date                                Phone

************************2017 MEDICAL CONSENT*************************
(Every volunteer needs to complete the Medical Consent in order to participate)

I, (please print)________________________________________,  hereby grant permission for a member of
Terror in the Dark Haunted House, to take whatever steps may be necessary to obtain emergency medical care
for the below named participant.  These steps may include, but are not limited to, the following:

  1. Attempt to contact a parent or guardian (if volunteer is a minor).
  2. Attempt to contact a family member.
  3. If we cannot contact any of the above we will contact a physician, call an ambulance, or transport
    the person to the Emergency Room at Rapid City Regional Hospital with the company of a Member
    of Terror in the Dark Haunted House.

In addition, Terror in the Dark Haunted House is not responsible for any injuries or accidents, lost or stolen items.

Signature of Volunteer______________________________________________Date:________________

Signature of Parent/Guardian________________________________________ Date:________________
                                                          (Mandatory if volunteer is a minor)
Please provide the following information in the event of an emergency:

Name of Volunteer:____________________________________Age:________ Phone:________________

Emergency Contact Name:______________________________Phone:________________

Relationship to Volunteer________________________________________________________________

Please list any health problems that we should know about (ie: Diabetes, Epilepsy, Heart Conditions, Allergies,
Back Problems, etc.)

___________________________________________________________________________________

___________________________________________________________________________________
CONSENT FORM
Simply print this printer-friendly webpage, fill it in, and then return it to one of the house coordinators.