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1. Parent/Guardian Information: Full legal name, ID number (KTP), relationship to child, contact details, and address of the parent or legal guardian
2. Child Information: Full legal name, date of birth, and any relevant identification numbers of the child
3. Institution Information: Name, address, and registration details of the institution requesting acknowledgement
4. Acknowledgement Statements: Clear, numbered list of specific items being acknowledged by the parent/guardian
5. Declaration of Understanding: Statement confirming that the parent/guardian has read, understood, and agrees to all terms
6. Signature Block: Space for parent/guardian signature, date, and witness signature if required
1. Medical Authorization: Optional section for authorizing emergency medical treatment, to be included when the form relates to activities or programs where medical emergencies might occur
2. Media Release: Optional section for obtaining permission to use child's photos/videos, to be included when the institution may need to document activities
3. Transportation Consent: Optional section for transportation permission, to be included when activities involve travel or field trips
4. Financial Responsibility: Optional section outlining financial obligations, to be included when the acknowledgement relates to programs or activities with associated costs
1. Schedule A - Program Details: Detailed description of the program, activity, or circumstances being acknowledged (if applicable)
2. Schedule B - Medical Information Form: Separate form for detailed medical information including allergies, conditions, and emergency contacts (if medical authorization is included)
3. Schedule C - Rules and Regulations: Complete list of relevant rules, policies, or guidelines being acknowledged
4. Appendix 1 - Emergency Contact List: List of emergency contacts and their relationship to the child
Education
Healthcare
Childcare
Sports and Recreation
Entertainment
Tourism
Youth Services
Religious Organizations
Cultural Organizations
Non-Profit Organizations
Legal
Administration
Operations
Compliance
Risk Management
Student Affairs
Enrollment
Program Management
Child Services
School Administrator
Program Director
Legal Counsel
Compliance Officer
Education Coordinator
Child Services Manager
Operations Manager
Enrollment Officer
Risk Management Officer
Student Affairs Coordinator
Activities Director
Administrative Assistant
Registration Coordinator
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