Youth Parent Permission

"*" indicates required fields

Student Name*
MM slash DD slash YYYY
Parent/Guardian Name*
Emergency Contact Name*

We have been advised of the nature and extent of the activities that may take place and represent to you that the participant is physically and mentally able to participate in those activities.

We understand that activities do present the risk of injury, or even death, to the participant, and we have advised the participant of those possibilities. We represent to you that we and the participant assume the risk of any such injury or death, and hold you, your agents, employees, volunteers, and representatives harmless from any liability for injury or death to the participant while engaged in this activity, and agree to indemnify and defend you against any claim or liability asserted against you for any such injury or death to participant.

We also hold you, your agents, employees, volunteers, and representatives harmless from all liability to any other person or entity arising as a result of the conduct of the participant in this activity and agree to defend and indemnify you, your agents, employees, volunteers, and representatives against any claim, loss, expense, damage, or liability arising as a result of such conduct.

If we are not personally present at these activities in which the participant is to participate, so as to be consulted in the case of necessity, you are authorized on our behalf to arrange for such medical and hospital treatment as you may deem advisable for the health and well-being of the participant.

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