Activity Registration/Permission
We are planning an activity as part of our programming that requires your permission prior to participation. We have provided you the details of the activity and request that you complete and sign the permission form. The safety of the youth is our primary concern. Precautions will be taken for their wellbeing and protection. Youth Unlimited YFC Highlands is collecting and retaining this personal information for the purpose of enrolling your youth in this activity. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Youth Unlimited YFC Highlands to limit the information collected, or to view your child’s information, please contact us. This form should be completed by the Parent/Caregiver if under 18 or by the individual participant if 18years or older.
Wonderland Amusement Park
Saturday, June 1, 2024. Tickets cost $30 each. Youth will be driven by staff and/or volunteers to this event.
Recurring
Please Select
Yes
No
YOUTH INFO
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Youth's personal email
*
example@example.com
Youth's phone number
*
Please enter a valid phone number.
Youth Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Any allergies or medical conditions that we need to be aware of for this/these events?
HOME ADDRESS
Is the youth at the same address as the parent?
*
Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PARENT/GUARDIAN INFO
Provide 2 different people's contact information
1st Parent/Guardian Name:
*
First Name
Last Name
1st Parent/Guardian Cell Phone
*
Please enter a valid phone number.
1st Parent/Guardian Email
*
example@example.com
Confirm Email
*
example@example.com
2nd Parent/Guardian Name:
First Name
Last Name
2nd Parent/Guardian Cell Phone
Please enter a valid phone number.
2nd Parent/Guardian Email
example@example.com
Confirm Email
example@example.com
Ticket Purchase
Tickets are $30 each. E-transfer payment to give@yfch.ca. Include parent and youth's name, plus event: Wonderland.
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CONSENTS
I/we hereby consent to the participation of my/our child in this supervised activity.
While every precaution is taken for their safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Youth Unlimited | YFC Highlands. I/we understand and accept these risks and agree that by allowing my/our child to participate in those activities, he/she may be taking part in a recreational activity that presents the potential for personal injury. I/we, the parents or guardians named below, authorize Youth Unlimited | YFC Highlands Program Personnel to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above. I/we, named below undertake and agree to indemnify and hold blameless Youth Unlimited YFC Highlands, its personnel, its Directors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities Youth Unlimited YFC Highlands, as well as of any medical treatment authorized by the supervising individuals representing Youth Unlimited YFC Highlands. This consent and authorization is effective only when participating in or traveling to.
Consent - Wellbeing
*
Yes
I give permission for the youth in my care noted above, to travel in a vehicle owned by Youth Unlimited (Highlands YFC), or by its staff or volunteers, for the duration of the program. I understand that drivers and their vehicles are licensed and insured according to local, provincial and federal laws, insurance policies and Highlands YFC’s Policies & Procedures. Furthermore, I do not hold Highlands YFC responsible for any harm that may occur to the youth in my care noted above, as a result of his/her willful participation in the transportation.
Consent - Transportation
*
Yes
I/We agree to permit Youth Unlimited YFC Highlands staff or volunteers to communicate with the participant via telephone, email, social media (Facebook, Instagram etc.) or text for the purpose of dissemination of information.
Consent - Communications
*
Yes
I do authorize Youth Unlimited YFC Highlands to take, use and own, in perpetuity; names, photographs or video/audio recordings of the youth in my care noted above, understanding that these may be used for public promotional purpose. Youth Unlimited YFC Highlands does not sell or give away any recorded materials or mailing list information.
Consent - Media
*
Yes
No
Signature
REMINDER: Ticket Purchase
Tickets are $30 each. E-transfer payment to give@yfch.ca. Include parent and youth's name, plus event: Wonderland. All payments must be submitted by Fri. May 17th.
Submit
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