Sunscreen & Hand Sanitizer Form – Spokane North East Youth Center

NEYC Sunscreen & Hand Sanitizer Form

Please list all children that you are registering in NEYC programming. Only one form per family is required.

URL

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Name

First Last

Name

First Last

Name

First Last

Please check the appropriate box:(Required)

I will provide sunscreen for my child with my child's name on it. NEYC staff may help my child apply sunscreen if necessary.

In the event that sunscreen provided by the parent/guardian is not available, I authorize NEYC staff to apply Coppertone Water Babies Sunscreen Lotion SPF50 to my child (Ingredients: Homosalate 9%; Octocrylene 9%; Avobenzone 3%; Octisalate 4.5%)

I DO NOT want my child to use sunscreen.

Please check the appropriate box:(Required)

My child may use Germ X Hand Sanitizer when needed.

I DO NOT want my child to use Germ X Hand Sanitizer.

Name of Signer(Required)

First Last

Signature(Required)

NEYC Sunscreen & Hand Sanitizer Form

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