I give my child approval to participate in any and all MAM activities and/or events at any and all MAM sites and partner sites.
I recognize that MAM OPERATES UNDER AN OPEN-DOOR POLICY AND IS NOT A DAY CARE CENTER.
I understand that if my child chooses to leave a MAM activity, event, or site on his/her own, MAM is not responsible for taking my child home.
I understand that MAM cannot be held liable if my child decides to leave the MAM premises on his/her own accord.
I agree to hold harmless and indemnify MAM, its directors, employees, or volunteers, for any liability sustained by MAM as a result of the negligent, willful, or intentional acts of my child, including expenses incurred.
I represent that my child is in good health and able to participate in the physical activities and vigorous workout of a sports activity. I understand every precaution will be taken for my child’s safety while participating in these activities.
I hereby authorize the MAM staff or volunteers to act on my behalf, according to their best judgment, in any emergency requiring medical attention. Specifically, I give MAM my consent to administer first aid and contact Emergency Medical Services if deemed necessary.
I do hereby waive, release, absolve, indemnify and agree to hold harmless MAM, the City of Memphis, Shelby County, any participating church or school, any activity organizers or sponsors, and any persons transporting my child to and from activities from any claim arising out of' an injury to my child, whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident and liability insurance.
I give permission for my child to ride with the MAM staff and/or volunteers to any activity, event, or site either in MAM arranged transportation or personal vehicles.
I hereby indemnify, release, forever discharge, and agree to hold harmless MAM, its directors, employees and volunteers, from any and all liabilities, claims or demands for personal injury, sickness or death, property damage, and expenses, of any nature which may arise or be incurred by my child that occur during any transportation and/or activities.
I give my consent for MAM to use my child’s images and/or voice in MAM’s publications, promotional materials, and/or on MAM’s website. I also give MAM permission to submit my child’s images and/or voice to other media for the purposes of promoting its own programs, events and activities.
Data Collection & Surveys
I understand that in order to provide services to youth and to measure program effectiveness, MAM conducts surveys and focus groups in which my child may be randomly asked to participate. I agree to allow my child to participate provided that his/her individual information is not released outside MAM.
I hereby authorize MAM to use any information that I supply about my child in an aggregate manner, but not individually, to assess program effectiveness and to publicly disseminate such data. I also authorize MAM to use outside services such as background services to assist in its data collection efforts provided such information is used in an aggregate manner and not individually.