Sample Parent Consent Using Google Forms

Customize your own parent consent form using Google Forms and samples below

In an effort to continuously serve members during the [Name of Organization] closure, [Name of Organization] is providing distance-based experiences through which staff will facilitate program activities through an online platform. We will use an application provided by a third party that members, parents/guardians and/or staff will access via the Internet and use for purposes of communication and programming. 

This letter seeks consent for your child to utilize the below online platforms for distance-based program purposes.

  • Google Classroom – requires internet and a device to connect; will be used to share projects/activities 
    • If you do not have access to the internet or a device, please contact us (we may be able to help) 
  • Zoom Meeting – requires the internet and a device to connect; used for meetings of Clubs, including [Name of programs], etc. 
  • Email – requires internet and a device to connect; used for communication
  • SchoolCNXT – requires internet access and a tablet/phone to connect through downloaded app or phone number; used for updates and communications
  • [Name of Organization] will also be posting content designed for learning and engagement to [Name of platforms]. However, due to the nature of these platforms, participation cannot be monitored by [Name of Organization] staff.

Please be aware that each site collects different information about its users and has its own privacy terms and conditions to which members must adhere. Please review these carefully before allowing your member to register for access to various platforms.

Our commitment to keeping the young people we serve safe is always our number one priority. [Name of Organization] will make every effort to protect member information as they use these platforms for [Name of Organization] programming. Further, all activities online must comply with [Name of Organization] safety policies.

* Required

Name of Children *

Parent/Guardian Phone Number *

Parent/Guardian Email *