I, herby attest that I am (we are) the legal parent/guardian(s) of the above-named youth and herby consent to the youth’s participation in the event/ program/activities being sponsored by YWCA Central Virginia, I do agree to the following conditions for allowing my youth to participate:
1. I represent that I am (we are) the parent or legal guardian (s) to consent to the registering youth participation this event/program.
2. I give permission for my youth to be photographed and videotaped for the sole purposes of promoting the YWCA Central Virginia programming.
3. I give permission for YWCA Central Virginia to transport my youth to activities.
4. I understand that this event/program is a non-profit and agree to waive on my behalf, or the behalf of the registered participant, any claim I and/or the participant may have against the registrant agency, any agent or employee of the agency, any sponsor of the event/program or any volunteer assisting in the event/program as a condition of my participant’s guardian.
5. I understand that my youth, participating in the Y GYRLS program of YWCA Central Virginia will engage in facilitated discussions on topics pertaining to, but not limited to: careers, personal safety, drug and alcohol prevention, health, diversity, conflict resolution, healthy relationships, social advocacy, and cultural heritage.
6. Participants MUST adhere to the program’s expectations for appropriate conduct. Youth who become disruptive may be dismissed from the program. Parents may be contacted and will be required to pick-up youth within 30 minutes. Parents may designate another individual over 18 years of age to pick up students but must inform agency prior to pick-up if the individual is not the emergency contact listed on this application.