Parental Consent and Release Form

I hereby voluntarily release, forever discharge the Seattle Solvers, its members, volunteer and agents from any and all claims, demands, or causes of action, which are connected with my child's participation in the programs or the use of the equipment and facilities. I agree to pay for any and all medical expenses incurred and give permission to the doctor or health care professional to provide medical care if necessary. I further grant Seattle Solvers permission to take and use photographs and/or video recordings of my child for educational presentations and promotional materials, including the organization’s website and social media.

The information I've given in this form is complete and accurate. By signing this form on      Date  , I confirm that I have fully informed myself of the contents of this Parental Consent and Release Form by reading it before I signed it. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effect.First NameLast NameSignature

I, the undersigned   First NameLast Name   , am the parent or legal guardian of the child/youth named   First NameLast Name, who was born on Date  and resides in   Street AddressAddress Line 2CityStateZip   . For any situation, I assure that I will be available for the phone call at    Area CodePhone Number   . As a parent or legal guardian, I affirm that I have been informed of the activities that the child/youth will participate in. I understand the general structure of the activities/programs and do not need to be informed of each and every activity.