Young Adventurer Program Application

Youth Adventurer Program Application

Young Adventure program is open to ages 6-12. Some events may have different restricted ages.
Section 1. Child Information

Thank you for your interest in joining LIVE (Lead, Inspire, Validate, and Explore)! Parent - Please complete the following application form to help us understand more about you and your interests.
Childs Name: *

First NameLast Name
Date of Birth*

MonthDayYear
Date
Childs Age:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.
We encourage applicants to apply for any and all programs they are interested in. However, please note that applying does not guarantee a spot in the program. Selection is based on availability and the suitability of the applicant to the program's goals and activities. We strive to create the best possible experience for all participants and appreciate your understanding and enthusiasm.
Please select the program you are interested in:*

Disneyland Enchantment (Ages 6 to 9)
Why are you interested in this program?*
How did you hear about LIVE?*
Is there anything else you would like us to know about you?*
Important Notice Regarding Transportation:

As many of our adventures will involve travel in a vehicle, please be aware that your child may require a booster seat for the journey. Do you have a booster seat available for use? Please let us know so we can make arrangements to ensure your child's safety during transportation.
- Children 2 years old or older, but under 8 years old, must be secured in a booster seat or child safety seat, unless they are 4'9" tall or taller.
- Children 8 years old or older, or those who have reached 4'9" in height, may use a regular seatbelt without a booster seat.
Do you have a booster seat you can provide?*

YesNo
Code of Conduct
Check each one for acknowledgement:*

Respect for Others: I will treat all participants, staff members, and volunteers with respect, courtesy, and consideration. I will refrain from any form of discrimination, harassment, or bullying.Safety First: I will prioritize my safety and the safety of others at all times. I will follow safety guidelines, instructions, and procedures provided by program leaders and staff.Environmental Stewardship: I will respect the natural environment and wildlife. I will minimize my impact on the ecosystem by practicing Leave No Trace principles and following park regulations.Teamwork and Cooperation: I will actively participate in group activities, contribute positively to team dynamics, and support my fellow participants. I will communicate openly, listen attentively, and resolve conflicts constructively.Accountability and Responsibility: I will take ownership of my actions and choices during the program. I will be punctual, reliable, and prepared for all scheduled activities. I will follow program rules and guidelines to ensure the smooth operation of the expedition.Adherence to Laws and Regulations: I will comply with all local, state, and federal laws, as well as program policies and regulations. I will refrain from engaging in any illegal or inappropriate behavior.Drug and Alcohol Policy: I understand that the use of drugs and alcohol is strictly prohibited during the program. I will not possess, consume, or distribute any illegal substances or alcoholic beverages.Communication: I will communicate openly and honestly with program leaders and staff. I will seek assistance if I have any questions, concerns, or issues during the program.
Section 2. Parent/Guardian Information
Parent/Guardian name (primary emergency contact):*

First NameLast Name
Relationship:*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Child's Medical Information

Thank you for providing this important information. It helps us ensure a safe and enjoyable experience for all participants.
Health Insurance Provider:*
Policy number:
Primary Care Physician:
Physicians Phone Number:*
Please enter a valid phone number.
Medical History:
Does the participant have any chronic illnesses or medical conditions?*

YesNo
If yes, please describe:
Is the participant currently taking any medication?*

YesNo
If yes, please describe:
Does the participant have any allergies (food, medication, environmental)*

YesNo
If yes, please describe:
Does the participant have any dietary restrictions?*

YesNo
If yes, please describe:
Parent Consent:

I hereby give my consent for my child to participate in the program organized by LIVE (selected above). I understand and acknowledge the following:
Mark each one to acknowledge:*

I have read and understood the program itinerary sent to me, including the activities and accommodations involved in the program.I am aware that my child will be under the supervision of adult leaders and staff members throughout the duration of the programI understand that outdoor activities such as hiking and snorkeling involve inherent risks, including but not limited to falls, injuries, and exposure to environmental hazards.I acknowledge that my child must follow safety guidelines and instructions provided by program leaders and staff to minimize risks and ensure theirIn the event of an emergency, I authorize the program staff of LIVE nonprofit to seek medical treatment for my child if I cannot be reached. I understand that every effort will be made to contact me before any treatment is administered.I agree to provide my child with any necessary medications, medical supplies, or equipment required for the duration of the program.I understand that my child's participation in the program is voluntary, and I release (LIVE) Lead, Inspire, Validate and Explore, its staff, volunteers, and affiliates from any liability arising from accidents, injuries, or damages incurred during the program.
Second emergency contact:
Name*

First NameLast Name
Relationship:*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Consent Agreement

By signing and submitting this application, I affirm that the information I have provided is true and complete. I agree to adhere to the rules and regulations of LIVE nonprofit and commit to the responsibilities assigned to me and I hereby grant LIVE nonprofit (Lead, Inspire, Validate, and Explore) permission to use photographs and/or video recordings of me (or my child, if under 18) taken during program activities for promotional purposes. This may include, but is not limited to, social media, website content, brochures, and other marketing materials. I understand that these images may be used without further notification or compensation.
Parent/Guardian Signature*

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Date*

MonthDayYear
Date
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Youth Adventurer Program Application

Section 1. Child Information

Code of Conduct

Section 2. Parent/Guardian Information

Child's Medical Information

Medical History:

Parent Consent:

Second emergency contact: