Parent Consent Form

PARENT / GUARDIAN CONSENT FORM

This form must be completed and signed by the Parent or Legal Guardian of any student who is a minor and is enrolling in an EC-Council certification program.

PARTICIPANT INFORMATION

Parent / Guardian Full Name *

Parent / Guardian Email Address *

Relationship to Student *

Student Full Name *

Contact Number *

Date of Birth (DD / MM / YYYY) *

EC-Council Program / Course Name *

Name of Academic Institution / Partner *

DECLARATION & CONSENT

I, the undersigned Parent / Guardian, confirm that the above-named student is my son / daughter / ward and that the date of birth stated above is accurate as per my knowledge. I hereby grant my full consent and permission for him / her to attend the EC-Council program identified above. I confirm that he / she will comply with all precautionary measures, guidelines, and the Code of Conduct issued by EC-Council in connection with the program * *

INDEMNITY & REPRESENTATION

I agree to indemnify and hold EC-Council, its officers, employees, and agents harmless at all times from and against any claims, liabilities, losses, damages, costs, and expenses (including reasonable legal fees) arising from any action, breach of terms, breach of representation or warranty, or any unlawful act by the above-named student during or in connection with the program. I represent and warrant that I have full legal authority to execute this consent and indemnity on behalf of the student. * *

SIGNATURE & DATE

Submission Date *

Parent / Guardian Signature *

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