Entrepreneur Opportunity & Recreation Program For Today's Youth
Permission and Independent Contractor's Agreement
Youth's Information
First Name
Last Name
Gender
Please Select
Male
Female
Date of Birth
*
/
Month
/
Day
Year
Preferred Start Date
*
School
Time Home
1
2
3
4
5
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Hour
00
10
20
30
40
50
Minutes
PM
AM/PM Option
Street Address
Zip Code
Home Phone
Cell Phone Number
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
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First Name
Last Name
Phone Number
Address
Emergency Contact 2
First Name
Last Name
Phone Number
Address
Medical Information
Preferred Hospital
Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns.
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Next
Signature Page
The Maryland Youth Club of America is a program which helps to provide youths with the opportunity to learn how to start and develop business fundamentals and earn by merit. Youths will get their start in being a young entrepreneur by selling products door-to-door as an Independent Contractor. The teens are supplied with the basics: merchandise, good sales tips, techniques, etc.
Terms
Check each box to agree
member receives merchandise on consignment and at regular intervals pays for what he/she has sold.
member can return any unsold merchandise (unopened and re-saleable) at any time for full credit to his/her account
member will receive his/her products from a distributor located in the youth's area. (The youth will learn how to manage inventory, money, receipts, etc.)
member can do business within his/her own community or he/she may choose to travel under adult supervision to different areas to get business or they choose a combination of the two. You, the parent/legal guardians are responsible for choosing a plan for your teenager.
Select One
Unsupervised
Supervised
Combination
Check box to agree
I have read the information on this agreement and as the parent/legal guardian of the youth listed above, I am giving my permission for him/her to become a member of Maryland Youth Club
Check box to agree
In case of an accident or sickness when my youngster is selling, while under adult supervision or on activity, I am giving the adult supervisor(s) my permission to proceed with whatever medical attention may be deemed necessary. I have written on this sheet any special medical/physical conditions about my youngster that those working with him/her should be aware of.
Full Name
Date
/
Month
/
Day
Year
Today's Date
Signature
Submit
Print Form
Parent/Guardian Information
Current Residence
Emergency Contact 1
Should be Empty: