BGC Liability Waiver and Release eFORMs rev. 9/2025

LIABILITY WAIVER eFORM

For Brown Girls Code (BGC) Clubs & Brown Girls WEE Code (BGWC) Clubs
Dear Parent or Legal Guardian:

You are required to read the following information very carefully and make sure that you understand it fully and sign it before allowing your child to participate in the activities, camps, events and/or programs hosted or sponsored by BROWN GIRLS CODE (BGC), BG WEE CODE (BGWC) CLUBS, or BROWN GIRLS IN TECH (BGIT).

I am fully aware that participation in BROWN GIRLS CODE (BGC) or BG WEE CODE (BGWC) CLUBS may result in risk of personal injury or harm to my child. I hereby agree to release and hold harmless BROWN GIRLS CODE (BGC), BG WEE CODE (BGWC) CLUBS, or BROWN GIRLS IN TECH - its, officers, employees, volunteers, committees, advisors and boards, from and against any and all liability, loss, damages, claims, or actions (including costs and attorney’s fees) for bodily injury and/or property damage, to the extent permissible by law.

This indemnification and hold harmless agreement shall include indemnity against all costs (including without limitation, reasonable attorney's fees and court costs), expenses and liabilities incurred in or in connection with any such claim or proceeding brought thereon and in defense thereof.

I further covenant and agree that I will not sue Brown Girls Code, its employees or Brown Girls in Tech for any claims for damages arising out of my child’s or children’s participation in this program. Further, this covenant not to sue shall be effective during the entire period of my child’s enrollment in Brown Girls Code plus twenty-four (24) months.

I have read and understand this release, indemnification and hold harmless form.

I voluntarily sign it and hereby give permission to BROWN GIRLS CODE, BGWC CLUBS, and/or BROWN GIRLS IN TECH for emergency transportation and/or treatment in the event of illness or injury.

I also hereby accept responsibility for the payment of any emergency transportation and/or treatment.

I further certify that my child is in good physical condition and has no medical or physical conditions that would restrict her participation in this activity or program.
Name of Child*

First NameLast Name
CHILD EMAIL ADDRESS
example@example.com
Date of Birth (Child)

MonthDayYear
Date
Grade
Emergency Contact Information

Parents/Legal Guardians will always be contacted FIRST. This section should include an additional person who can be contacted in lieu of an emergency where we are unsuccessful in reaching the parent/legal guardian.
EMERGENCY CONTACT PERSON (MUST BE SOMEONE OTHER THAN PARENT/GUARDIAN)*

First NameLast Name
Relationship to Child (i.e. father, grandmother, family friend, etc.)
Parent/Legal Guardian should not be listed here
EMERGENCY CONTACT Phone Number

Area CodePhone Number
Name of Parent/Guardian*

First NameLast Name
PARENT/GUARDIAN Phone Number

Area CodePhone Number
PARENT/GUARDIAN EMAIL ADDRESS
example@example.com
Signature of Parent/Guardian*

Clear
Date Signed *

MonthDayYear
Date

PHOTO & SOCIAL MEDIA RELEASE eFORM

For Brown Girls Code (BGC) Clubs & Brown Girls WEE Code (BGWC) Clubs
Name of Child*

First NameLast Name
Photo | Image | Video Consent*

Brown Girls Code (BGC) and Brown Girls in Tech (BGIT) HAVE MY Permission to use my or my child’s photograph (incl. image, video) publicly to promote the club, camps or events and activities associated with the club (includes use with BGC & BGIT Partners and Sponsors).
Marketing and Printed Publications Consent*

I understand that the images and/or videos may be used in print publications, marketing materials, annual reports, postcards, flyers (printed and/or electronic), magazine articles, online publications, presentations, local media, websites, social media and any other published material for the benefit of Brown Girls Code (BGC) and/or BROWN GIRLS IN TECH (BGIT), sponsors and partners.
Compensation*

I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
Recorded Sessions*

I understand that BGC & BGWC Virtual Clubs will be recorded. I understand that clips from the recordings can be used to promote the Coder's projects and presentations.
Name of Parent/Guardian*

First NameLast Name
Signature of Parent/Guardian*

Clear
Date Signed *

MonthDayYear
Date

BGC GENERAL PARTICIPATION RELEASE eFORM

For Brown Girls Code (BGC) Clubs & Brown Girls WEE Code (BGWC) Clubs
Name of Child*

First NameLast Name
Consent

I give my consent for the child named above to participate in online and/or in-person Club activities, camps or events shared and/or created by BROWN GIRLS CODE (BGC) and/or BROWN GIRLS IN TECH (BGIT). I understand that BGC & BGWC Virtual Clubs will be recorded. Coders may be provided with links to view recorded instructions following club as needed/requested. I agree to release and hold harmless BROWN GIRLS CODE (BGC) and/or BROWN GIRLS IN TECH, its directors, organizers, supervisors, employees, participants, volunteers, and other persons assisting or overseeing such activities in the event of injury resulting from activities related to BROWN GIRLS CODE (BGC) and/or BROWN GIRLS IN TECH (BGIT) in-person and/or virtual events.
Name of Parent/Guardian*

First NameLast Name
Signature of Parent/Guardian*

Clear
Date Signed *

MonthDayYear
Date

Waiver of Liability Relating to Coronavirus/COVID-19 eFORM

For Brown Girls Code (BGC) Clubs & Brown Girls WEE Code (BGWC) Clubs
Name of Child*

First NameLast Name
Dear Parent or Legal Guardian:

You are required to read the following information very carefully and make sure that you understand it fully and sign it before allowing your child to participate in the activities and/or programs hosted or sponsored by BROWN GIRLS CODE (BGC), BG WEE CODE (BGWC) CLUBS, or BROWN GIRLS IN TECH (BGIT).

The novel coronavirus, COVID-19, was previously declared as a worldwide pandemic by the World Health Organization. COVID-19 (to include any coronavirus variants) is reported to be mildly to extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread the disease. The exact methods of spread and contraction vary, and there is no known cure for COVID-19 (to include any coronavirus variants). Evidence has shown that COVID-19 (to include any coronavirus variants) can cause serious and potentially life-threatening illness and even death.

BROWN GIRLS CODE cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 (to include any coronavirus variants) while utilizing BROWN GIRLS CODE’S services or premises. It is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize Brown Girls Code services and/or enter onto BROWN GIRLS CODE'S premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19 (to include any coronavirus variants).

ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 (to include any coronavirus variants) for myself and/or my children in order to utilize BROWN GIRLS CODE'S services and enter BROWN GIRLS CODE'S premises. These services are of such value to me [and/or to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 (to include any coronavirus variants) in order to utilize BROWN GIRLS CODE'S services and premises in person [if applicable: “rather than arranging for an alternative method of enjoying the same services virtually (e.g., videoconference)].

WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against BROWN GIRLS CODE, BGWC CLUBS, and/or BROWN GIRLS IN TECH and its owners, officers, directors, managers, officials, trustees, agents, employees, volunteers or other representatives in connection with exposure, infection, and/or spread of COVID-19 (to include any coronavirus variants) related to utilizing Brown Girls Code's services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen, or unforeseen.

I also hereby accept responsibility for the payment of any emergency transportation and/or treatment.

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:
CHOICE OF LAW: I understand and agree that the law of the State of _______ will apply to this contract.
Type Your State Name Here
Name of Parent/Guardian*

First NameLast Name
I voluntarily sign it and hereby give permission to BROWN GIRLS CODE, BGWC CLUBS, and/or BROWN GIRLS IN TECH for emergency transportation and/or treatment in the event of illness or injury.

I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.
Signature of Parent/Guardian*

Clear
Date Signed *

MonthDayYear
Date

Brown Girls Code Wellness Policy eFORM

For Brown Girls Code (BGC) Clubs & Brown Girls WEE Code (BGWC) Clubs
Name of Child*

First NameLast Name
Brown Girls Code (BGC) has created a wellness policy for BGC in-person club sessions, Community, and volunteer events, and for any other BGC related events for Brown Girls Code members and attendees. Our priority is keeping our BG Coders, Staff, and volunteers safe to the best of our efforts.

1. Individuals exhibiting any symptom of COVID-19 (to include any coronavirus variants), whether they receive a positive COVID-19 test or not, should not attend in-person BGC club sessions, camp or related events until at least 10 days have passed since symptoms first appeared, AND they have been asymptomatic for at least 24 hours.

2. Individuals who have had close, prolonged contact with someone else who exhibits symptoms of COVID-19 (to include any coronavirus variants), likewise should not attend in-person BGC Club Sessions, camps or events until at least 10 days have passed since that person first exhibited symptoms, AND that person has had no symptoms for at least 24 hours.

3. Individuals who previously tested positive for COVID-19 (to include any coronavirus variants) and have had no symptoms may attend in-person BGC events after 10 full days have passed following their negative test.

4. Individuals who test negative for COVID-19 (to include any coronavirus variants) and have had no symptoms may attend in-person BGC events right away.

Please Note:

* Masks are currently not required for in person BGC club sessions, camps and/or events. If you or your Child need a mask, please bring one with you.

* If you or your child have any potential symptoms of COVID-19 (to include any coronavirus variants) or have possibly been exposed to someone infected in the past two weeks, please remain at home.

* If you or your child presents symptoms for other viruses or communicable diseases, please use good judgment, and keep your child home.

Additional Precautions:

* Hand sanitizer is available.

Questions?

If you have any questions or are uncertain about what these guidelines mean for you, please contact us (browngirlcoders@gmail.com) and we will be happy to assist you.
I have read the Brown Girls Code Wellness Policy and agree to adhere to this Policy.

I agree.
Name of Parent/Guardian*

First NameLast Name
Signature of Parent/Guardian*

Clear

Should be Empty:

LIABILITY WAIVER eFORM

Emergency Contact Information

PHOTO & SOCIAL MEDIA RELEASE eFORM

BGC GENERAL PARTICIPATION RELEASE eFORM

Waiver of Liability Relating to Coronavirus/COVID-19 eFORM

Brown Girls Code Wellness Policy eFORM