I hereby give permission for the participant listed above to take part in the Activate Program activities, which may include off-site events, academic assistance, continuing education, and recreational programs. Activate Summer Camp has permission to provide my child with food and water over the course of the camp day.
If an emergency arises, program staff will take all steps necessary to ensure the safety of the participant and will call, if necessary, a public emergency vehicle for transportation to an emergency facility. I understand that I will be responsible for any transportation charges and/or medical expenses incurred. I agree that if a health condition exists now or in the future which would impact the participation of the student named above, I will notify the Activate Program Staff.
I give my consent to Youth Empowerment Source, and the Activate Staff to take the participant's photograph, video, or audio during the program, to be used for education or marketing purposes.