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If your child or children are attending a Strive Academy event, please fill out the Parental Consent Form below.  

Parental Consent Form

Parent/Guardian Information:

Participant's Information:

Medical Information

Does the child have any allergies?
Does the child take any medications on a regular basis?
Please check any medical conditions that your child has

Emergency Contact Information


In the event that I, the Parent or Guardian, cannot be reached in an emergency, I hereby give my permission to Strive Academy, LLC to transport my child for medical care, and to the physician or dentist selected by Strive Academy, LLC to hospitalize, to secure proper treatment, and/or order an injection, anesthesia, or surgery for my son or daughter as deemed necessary. 

Every activity sponsored by Strive Academy, LLC is carefully planned and adequately supervised by mature adults.  However, even with the best of planning and precaution, unforeseen events can occur.  By signing this form, the parent or guardian agrees to assume all risks and hazards inherent in the summer camp or program. They also agree to not hold Strive Academy, LLC, or volunteer assistants liable for damages, losses, or injuries to the person or property of the undersigned.  The parent or guardian understands that they are signing for the minor listed on the form and the signature is for both medical and liability release. 

I, the Parent or Guardian, give consent to use any photographs taken or digital images taken of my child during his/her participation in the Strive Academy summer camps or programs for future Strive Academy brochures, website, and other promotional purposes.  Pictures may also appear in local media. 

Coronavirus/COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact.  Federal and state authorities recommend social distancing as a means to prevent the spread of the virus.  COVID-19 can lead to severe illness, personal injury, permanent disability, and death.  I hereby agree and represent and warrant that neither myself nor such participating children as listed above shall visit or utilize the facilities, services, and programs of Strive Academy, LLC if myself or such participating children (i) experiences symptoms of COVID-19, including, without limitation, fever, cough or shortness of breath, or (ii) has a suspected or diagnosed/confirmed case of COVID-19.   I hearby agree to notify Strive Academy, LLC immediately if I believe that any of the foregoing access/use restrictions may apply. Strive Academy, LLC in no way warrants that COVID-19 infection will not occur through participation in Strive Academy, LLC programs. 

I have read and agree to the above information

Thanks for submitting!
We look forwarding to seeing you at Strive Academy.

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