Skate Party Consent Form_2016

Thursday, April 14th, 2016 6:00-8:00PM
Pattison’s West Skating Center
34222 Pacific Highway South
Federal Way, WA 98003
Name of Skater:
I give permission for my child to participate in the Molen Orthodontics Skate Party at Pattison’s West Skating Center. I release Molen
Orthodontics from any responsibility of my child. Photos taken at
this event may be used for Molen Orthodontics marketing
purposes.
**Participants under the age of 18 need to have a signed
consent form upon entry**
Signature of Parent or Guardian