Functions and Activities
Prior to my child/youth’s participation in activities associated with PATHFINDERS RESOURCES, I acknowledge that there are certain risks associated with the activities including, by way of example, physical injury due to activity related accidents, physical injury due to transportation related accidents, illness, or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware.
Release of Liability
I (the parent/guardian), hereby agree to release, waive, forever discharge, hold harmless, defend and indemnify PATHFINDERS RESOURCES, their agents, officers, boards, volunteers, and employees from any and all liability and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of his/her participation in activities or transportation involved with the any programs or childcare provided by PATHFINDERS RESOURCES. I also give permission for my child to travel and participate in activities with the staff of PATHFINDERS RESOURCES.
I understand that this program will periodically entail sport/physical activities in order to promote self-confidence, teamwork, perseverance, and stress relief. It is my responsibility to provide PATHFINDERS RESOURCES with notification in writing of any knowledge of limitations that would require the above-named youth to have special accommodations made or to not participate in any physical activity within the program in any capacity.
First Aid and Emergency Medical Treatment
I (the parent/guardian), recognize that there may be occasions where the child named above may be in need of first aid or medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of PATHFINDERS RESOURCES to seek and secure any medical attention or treatment for the child named above, including hospitalization, if in the agent’s opinion such need arises. In doing so, I agree to pay all fees and costs arising from this action to obtain medical treatment. I give permission for attending physicians(s) and other medical personnel to administer any needed medical treatment, including surgery and, again, I agree to pay for the medical treatment.
Permission to Transport Youth
I (the parent/guardian), give PATHFINDERS RESOURCES the permission to transport my minor child in an authorized staff vehicle, driven by an individualauthorized by PATHFINDERS RESOURCES. I understand my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or staff. As a condition for the transportation received, I, and/or my child further agree to release and forever discharge PATHFINDERS RESOURCES, and their agents, officers and employees from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation.
Permission to be Paired with Other Youth/Group Activities
I (the parent/guardian), give permission for the above name youth to be paired with other youth during their service sessions while under the supervision of the PATHFINDERS RESOURCES' staff member. I understand that this program will periodically entail group activities to promote social skills, self- confidence, teamwork, perseverance, stress relief and any therapeutic need as it is listed in the service plan. I am aware that I have the right to request the suspension of pairing my child/dependent with other youth during treatment. I also understand that I need to provide the request to suspend pairing or group activity in writing.
I represent that I am the parent/guardian of the above child, who is under 18 years of age. I have read the above Permission/Waiver Form and am fully familiar with the contents thereof.
I understand this authorization is valid until December 31, 2022.