CAREFULLY READ AND COMPLETE THE REQUIRED ACKNOWLEDGEMENTS BELOW

➔ The above information is true to the best of my knowledge. As the parent/guardian of the above-named participant, I give permission for my child to participate in all Girls Teen Summit activities. My child has my permission to be transported to and from this activity. I understand that neither the Girls Teen Summit and/or the Tulsa Dream Center, nor any of its agents are responsible for any injury or casualty sustained by my child. If a medical emergency occurs
and I cannot be reached or my child needs immediate care, I authorize the staff of Soaring Eagles and the Dream Center to use their best judgment in taking my child to a hospital and/or contacting a medical professional. I further agree to be responsible for any charges incurred in relation to obtaining such medical care.

PHOTOGRAPHY RELEASE:

➔ During the course of the Girls' Teen Summit activities., photos and or video will be taken. Please indicate below if you give permission to use and/or publish photos/video of you or your youth obtained during the event.

➔ All attendees will be responsible for any personal items brought to the event. Girls Teen Summit, Tulsa Dream Center and any of their agents, representatives, and/or volunteers will not be responsible for lost or stolen items. Disruptive conduct will not be tolerated. Any attendees who are deemed to be unruly or disorderly will be required to leave the premises. Transportation from the event will be the responsibility of the parent/guardian.

➔ We at Soaring Eagles Youth & Family Services encourages girls to seek out and get connected with organizations that provide various services that help positively impact the lives of each girl. While we encourage connecting with mentors, we advise that the girls first connect with an official organization and through the organization to be partnered with an individual mentor. We do NOT advise girls to exchange numbers with event volunteers. Should your child exchange numbers with an event volunteer, Soaring Eagles Youth & Family Services, The Tulsa Dream Center and any other company or organization connected to Girls' Teen Summit shall NOT be held liable for the outcome of relationship.

The undersigned parent/guardian hereby releases Soaring Eagles Youth & Family Services and The Tulsa Dream Center its employees, agents, Board of Directors, and their respective successors and assigns from any and all claims,
damages and liabilities, including, without limitation, personal injury, bodily injury, and damage to, or loss of, personal property, including and all costs or expenses related thereto, without limitation, which may be incurred by the
undersigned and/or the child identified herein, as the direct or indirect result or consequence for any event which may occur or arise from the attendance and/or participation of the child identified herein, in the event described above,
including transportation to and from said event.

*Please complete a separate form for each student.

Soaring Eagle’s Youth and Family Service’s. Inc. is dedicated to the health and safety of our teens and volunteers. Parent/guardians’ commitment to keep their kids home from the GTS under the circumstances listed below is a very important part of keeping the GTS at the Tulsa Dream Center healthy and sustaining uninterrupted in-person learning.

By signing this form, you acknowledge your responsibility and agreement for the GTS to keep your teen home if:

1. A member of the household is positive for COVID-19 or is awaiting test results after having had contact with a positive case of COVID-19.

2. A member of the household is experiencing COVID-like symptoms.

3. Student has had close contact with someone diagnosed with COVID-19 within 14 days.

4. Student is experiencing fever of 100 degrees or higher.

5. Student is experiencing any of the following unexplained symptoms (fever or chills, cough, shortness of breath, fatigue, muscle or body aches, sore throat, congestion or runny nose, nausea or vomiting, diarrhea, headache, loss of taste or smell).

Should any of the above apply to your teen, please refer to your healthcare provider for testing and care and contact the Executive Director Premadonna Braddick by phone (918-892-1797).