Youth Hike & Wellness Registration - June 15th
To register more than one youth, please fill out a separate application for each youth.
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Youth Information
Youth Name
*
First Name
Last Name
Youth Phone Number
*
Format: (000) 000-0000.
Youth Email
*
example@example.com
Age
*
Gender
*
Male
Female
Parent Information
First Parent Name
*
First Name
Last Name
First Parent Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
First Parent Email
*
example@example.com
Second Parent Information
Emergency Contact (Please enter contact information for an emergency contact (different than parent) who we can contact in case parents cannot be reached)
*
Photo Release Authorization
*
I grant permission for photos or videos taken of me or my child(ren) during MAS Bay Area events/classes/camps/activities to be used on the MAS Bay Area website, in brochures, on social media, and in newsletters for promotional, educational, or informational purposes.
I do not give permission to be photographed, and if I am, I request that my photo not be published.
Liability Waiver
*
By submitting this form, I release and agree to indemnify and hold harmless MAS Bay Area and its officers, employees, agents, and volunteers from any liability, claims, damages, or costs arising from my and/or my child’s participation in MAS Bay Area events, classes, camps, activities, or transportation provided by volunteers, whether conducted at the MAS Bay Area Office, during transit, or at any other sites where such events may take place.
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