PARENT / GUARDIAN CONSENT & PARTICIPATION 

I, the undersigned parent/guardian, give permission for my child to participate in the Rotary District 5930 Youth Summit, Four-Way Test Contest, and/or related district youth events. 

I understand this is a Rotary District 5930 event and not a school-sponsored activity. Participation is voluntary and may include leadership, educational, and group activities.

Rotary District 5930 is committed to maintaining a safe environment for all youth participants and follows Rotary International Youth Protection policies. Youth participants will be supervised by screened and trained volunteers in accordance with these guidelines. 

 

MEDIA AUTHORIZATION

I grant permission for my child to be photographed, recorded, or videotaped during the event.

I authorize Rotary District 5930, Rotary International, affiliated Rotary Clubs, and event participants and partners (including guest speakers, volunteers, and collaborating organizations) to use such images, audio, or video recordings for educational, promotional, and public relations purposes, including, but not limited to, websites, social media, newsletters, presentations, and printed materials.

I understand that these materials will be used in a manner consistent with Rotary’s youth protection policies and standards of respect and dignity, and that no compensation will be provided for such use.

 

RELEASE & ASSUMPTION OF RISK 

I acknowledge that reasonable precautions will be taken to ensure the safety and well-being of participants. I understand that participation in the event involves certain inherent risks and, on behalf of my child, I voluntarily assume such risks. I agree to release and hold harmless Rotary International, Rotary District 5930, affiliated Rotary Clubs, and event participants and partners (including guest speakers, volunteers, collaborating organizations, sponsors, and facility providers) from any claims or liabilities arising from my child’s participation, except in cases of gross negligence or willful misconduct.

 

MEDICAL AUTHORIZATION

In the event of a medical emergency, I authorize Rotary District 5930 event staff and designated volunteers to obtain necessary medical treatment for my child, including emergency care and transportation if required. Reasonable efforts will be made to contact me or the emergency contact listed. I accept responsibility for any medical expenses incurred.

 

CODE OF CONDUCT

I understand my child is expected to follow all instructions provided by event staff and volunteers and to behave respectfully. Rotary District 5930 is committed to maintaining a safe environment in accordance with Rotary Youth Protection policies. Failure to comply may result in removal from the event and notification to the parent/guardian.