3. CMM Junior Docent Program
   

   Parent/Guardian Form
6. Applicant's Name*
7. Today's Date
   Today's Date
9. Parent/Guardian Name(s)*
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Home Phone*
20. Cell Phone
21. Work Phone
23. School*
25. Applicant's Email Address*
26. Parent's Email Address*
30. Question 1
    Who can we contact in case of emergency other than the Parent/Guardian?
31. Name*
33. Phone Number*
34. Relationship to Jr Docent*
38. Question 2*
    Does the applicant have any allergies or other special medical or physical needs which we need to be aware of?
39. Question 3*

    May we have your permission to use photographs of your child to promote the Calvert Marine Museum programs?

    1. Yes

    1. No
41. Question 4a*

    If selected, your child will be coming to the Museum an average of twice per month for two years. Will they have reliable transportation to and from the Museum?

    1. Yes

    1. No
42. Question 4b*

    If selected, are you committed to helping them follow through with such a program?

    1. Yes

    1. Maybe
46. Needed to complete application

    This form along with the Junior Docent Program Application and a Recommendation Form must be submitted NO LATER THAN April 1, 2023.

47. Parent/Guardian Agreement*
    By initialing this box you show that you have read your child's Junior Docent Application and give your approval and support for your child to participate in the Calvert Marine Museum's Junior Docent Program.
49. Questions?
    Contact Mindy Quinn at 410-326-2042, ext. 8081 or mindy.quinn@calvertcountymd.gov
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field