By signing (typing) below I/we named above have read, understand and agree to the following and allow our son/daughter/ward to participate in KSM Youth program.
I understand KSM Youth Program is a drop in program where participants are free to come and go as they please. Kerr Street Mission can not ensure the safe arrival and departure of any participant to and from 485 Kerr St. KSM can not ensure the safety or location of participants who choose to leave the KSM building, it’s program activities or outside program hours. All risk outside the KSM building or outside it’s program activities or hours is the responsibility of the participant and their parent(s) and or guardians.
I understand that KSM Youth Program might include activities that take youth outside of 485 Kerr Street. These places could include nearby parks and streets or local businesses and restaurants. All of these activities will be within walking distance of the KSM building. These activities will be supervised by KSM staff or volunteers and happen within program hours. Trips or activities that include vehicle travel and or fall outside program hours will require an additional permission form.
I understand in the case of an emergency all attempts will be made to contact the participants parent and or guardian. In the event that that person can not be contacted I authorize the staff of Kerr Street Mission 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 understand that any recreational activity involves risk to participants including personal injury or loss or damage to personal property. I understand and agree to indemnify and hold blameless the staff, board and volunteers of Kerr Street Mission from and against any loss, damage or injury suffered by the participant as a result of participating in the KSM Youth program and all it’s activities.