Kaleo Project Drop In Consent Form

YFC Canada

YFC is a national organization built on local chapters.

Registered Charity #106868847RR0001

YFC Okanagan

Registered Charity #106868847RR0001

Kaleo Project Drop In Consent Form

Parent or Guardian Consent Form
Students Name*
First Last
Preferred Name
Student Age*
Student's Birthday*
Parent / Guardian Name*
First Last
Parent / Guardian Phone Number*
Parent / Guardian Email*
Your Relationship to Student*
Student Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Known Allergies, Medical Conditions or Current Medications
Transportation & Liability*
I agree to the policy
Transportation Consent:

By agreeing to the travel and transport policy, I (the parent or guardian) agree to allow my student to travel in approved vehicles with approved Staff and Volunteers for the purpose of Youth Unlimited programs (Including Downtown Club). This may include the use of a dash cam in vehicles when necessary.

Liability Release:

By agreeing to the Liability Release Policy, I release Downtown Club / YFC Okanagan/Youth Unlimited, its staff, and volunteers from liability for any injury or loss that may occur during participation, except in cases of negligence.
YFC / Youth Unlimited Okanagan Consent*
I agree to the policy
Medical Consent:

I/We authorize the administration of any first aid treatment necessary, and in the case of medical emergency, give permission to the Physician selected by the supervisors to hospitalize and secure proper treatment for my child as named above. Every effort will be made to contact parents or guardians before such action.

I/We acknowledge that it is my responsibility to take the necessary steps for insuring against personal injury, property damage, or any loss by my child or by self. I also acknowledge that I must assume total responsibility for ALL medical coverage, accidental insurance and personal injury, or any other loss or damage. I will also pay for the cost to have my child sent home if he/she is unwilling to comply with the rules.

Photos/Media Release:

I/We agree to permit reasonable use of photos, videos, written materials or other pictures of applicant student in promoting YFC/YU and their activities and programs. We understand that these could appear in agency newsletters, brochures, website or social media; or in local newspapers, on television, and might identify participants by first name. We wish to inform you of this in advance in order to avoid any surprises or misunderstandings.

Communication:

A policy is in effect that communication is to be used solely for the dissemination of information. I/We agree to permit YFC/YU staff or volunteers to communicate with applicant student via telephone, email, social media or text.

Purposes and Extent:

YFC/YU is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to develop and nurture on-going relationships with you and your child, and to inform you of program updates and upcoming opportunities at our organization. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish YFC/YU to limit the information collected, or to view your child’s information, please contact us.
Acknowledgement*
By signing below, I, (parent/guardian listed above), give permission for my child, (youth listed above), to participate in the Downtown Club’s Drop In Program with Youth Unlimited.
Signature*
Your Name
Your Name
Your Name
A Parent / Guardian Signature is required for all participants under the age of 19. Participants 19 and older can sign for themselves.