| Statement of Parentage and Consent
Please print this page, fill it out, attach a family photo and send it in with your check.
The undersigned hereby represents that he/she is the parent or legal guardian of the following named minor(s). The undersigned further represents that it is his/her desire that the minor children listed on this form be admitted to the Buffalo Chip Campground. This is done with full knowledge that the minors may observe some nudity or other activity which some individuals may deem inappropriate for viewing by a minor.
The undersigned is familiar with bike rallies and common activities which can be expected at such gatherings, and expressly consents to his/her childrens' presence at the campground.
| PLEASE PRINT |
| ___________________________________ |
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| ___________________________________ |
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| ___________________________________ |
___________________________________ |
| ___________________________________ |
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| Parent/Guardian |
___________________________________
Signature |
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Date |
PLEASE ATTACH FAMILY PHOTO
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