Minor Safety Form

Parent / Guardian Full Name *

First Name

Last Name

Phone

(###)

###

####

Minor Registration *

Complete drop down questions for each minor you will be responsible for for during Revival.

Minor #1

Minor #2

Minor #3

Minor #4

Minor#5

Minor #6

Acknowledgments *

By submitting this for you are agreeing to the terms below and agree to the liability terms and conditions listed in your ticket holder agreement.

I have read and agree to the Children and Minors Policy above.

I understand Revival cannot administer medications to minors.

I understand I must show matching ID to reclaim my child.

I understand that failure to properly supervise my child may result in removal. 4

I understand that if my child is unaccompanied > 60 minutes, law enforcement will be notified.