THE PARENT: {parentguardian1}
THE PARTICIPANT(S): {child_1_name} {child_2_name} {child_3_name}
I, THE PARENT, am the parent/legal guardian of THE PARTICIPANT, who has my permission to attend and participate in Kerr Street Kids' Clubs run by Kerr Street Community Services, operating as Kerr Street Mission located at 485 Kerr Street, Oakville. I have read and completed the application and confirm all information is correct.
THE PARTICIPANT hereby agrees to abide by the behavioral guidelines for the Kids' Clubs and the parent agrees that in the event that THE PARTICIPANT fails to comply with the guidelines or behaves in such a way as is likely to cause damage or injury to persons or property while at Kids' Clubs, THE PARTICIPANT may be sent home at the parent’s expense and the parent shall be responsible for any costs incurred in rectifying any damage.
THE PARENT hereby authorizes the administration of any first aid treatment that may be deemed necessary by any of the Kerr Street Mission staff. In the event of a more serious medical emergency affecting THE PARTICIPANT, the staff shall make all reasonable efforts to contact the parent/guardian. Where attempts to contact the parent are not successful or are not feasible due to the urgency of the situation, the staff are hereby authorized to obtain the services of a duly licensed physician and to secure appropriate treatment for THE PARTICIPANT. The parent hereby confirms that THE PARTICIPANT is covered by OHIP or equivalent medical insurance.
I GIVE THE PARTICIPANT PERMISSION to travel by foot within the community without prior notice to participate in Kids' Clubs programming over the course of the program. In addition I give permission to travel by bus on any field trips during the program, provided I am given notice of the destination and time of the trip. If THE PARTICIPANT requires any accommodations or modifications to program, it is THE PARENT'S responsibility to notify Kerr Street Mission prior to the start of Kids' Clubs.
THE PARENT AND THE PARTICIPANT hereby acknowledge that there are inherent risks involved in the travel and group activities which comprise the Kids' Clubs, and voluntarily elect to assume said risks as their sole responsibility. The parent and THE PARTICIPANT hereby release Kerr Street Community Services employees, agents, board of directors, volunteers from any and all liability, claims, damages and costs for loss, personal injury, accident, misfortune or damage to THE PARTICIPANT or his/her property while participating in events sponsored by Kerr Street Mission. It is understood that Kerr Street Mission shall take reasonable precautions to provide for the health and safety of THE PARTICIPANT.