Summer Boating Program Permission Form

Students Name*

*Please write full first and last name

Students Age*

Students Gender*

Students Personal Health Card Number*

*Please read and check the medical consent section

Parent / Guardian Name*

*Please write full first and last name

Parent / Guardian Phone Number*

Parent / Guardian Email*

Emergency Contact Phone Number

*If different than Parent or Guardian phone number

Address*

Street Address Unit # City State / Province / Region ZIP / Postal Code Country

Does your student know how to swim?*

Yes
No

Students Swimming Ability Level*

Please enter a number from 1 to 10.

1 being poor and 10 being excellent

YFC / Youth Unlimited 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 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 staff or volunteers to communicate with applicant student via telephone, email, social media or text.

Purposes and Extent:

YFC 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 to limit the information collected, or to view your child’s information, please contact us.

Parent/Guardian Options:

I/we, named below, undertake and agree to indemnify and hold harmless YFC, Program Personnel, YFC CANADA, its trustees, directors, corporation members, servants, agents, volunteers, employees and all program personnel (Including sponsors “Mission Group Enterprises Aqua Marine Valet”, and “Howard and Amanda Neilson of Kelowna, B.C.”) from any and all actions, causes of actions, claims and demands whatsoever whether existing as of this date or in the future; and, against any loss, damage or injury suffered by the participant as a result of being part of the activities of YFC CANADA, as well as of any medical treatment authorized by the supervising individuals representing YFC CANADA. This consent and authorization is effective only when participating in or traveling to events sponsored by YFC CANADA.

Mission Group Consent*

I agree to the policy

RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

TO: Mission Group Enterprises Ltd. (“Mission Group”)

Mission Group shall make its services available to take participants on a boat for an afternoon on the Okanagan Lake (the “Event”) and participate in water sports and activities, which may or may not include the use of a motorboat, waterskiing, wakeboarding, kneeboarding, tubing, swimming, diving, fishing and use of personal watercrafts (collectively, the “Activities”).

I wish to attend the Event and participate in the Activities. I am aware that the Activities involve many inherent risks, dangers and hazards, including but not limited to: the use of motorboats; changing weather conditions including storms; natural and man-made obstacles; other boatcraft and people using the lake for recreational or commercial purposes; impact or collision with other boaters and/or other people using the lake for recreational or commercial purposes; negligence of other boaters and people using the lake for recreational or commercial purposes; and negligence of guests at the Event. I freely accept and fully assume all such risks, dangers and hazards and the possibility of personal injury, death, property damage or loss, resulting therefrom.

I represent that I am physically capable of safe participation in any of the Activities and I will immediately inform Mission Group if I am unable or become unable to safely participate in any of the Activities.

I agree as follows:

1. To waive any and all claims that I have, or may have in the future, against Mission Group its subsidiaries, and its directors, officers, employees, agents, volunteers and representatives (collectively, the “Releasees”);
2. To release the Releasees from any and all liability for any loss, damage, injury or expense I may suffer or that my next of kin may suffer as a result of my involvement in the Activities, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF STATUTORY DUTY OF CARE ON THE PART OF THE RELEASEES;

3. To hold harmless and indemnify the Releasees from any and all liability for any property damage or personal injury to any third party resulting from my conduct during the Activities;
4. That this Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators and assigns, in the event of my death; and
5. If the Releasor is not the age of majority, the Guardian shall INDEMNIFY THE RELEASEES in full from any loss, cost, damage, injury and expense of any nature, including legal fees incurred FOR ANY CLAIM OR CAUSE OF ACTION BROUGHT BY OR ON BEHALF OF THE RELEASOR AGAINST THE RELEASEES.

I HAVE READ AND UNDERSTAND THIS AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS which I or my heirs, next of kin, executors, administrators and assigns may have against the Releasees.

I am also aware Mission Group reserves the right to immediately remove me from the Event should Mission Group consider my conduct to be dangerous, reckless or otherwise unsafe.

Signature*

A Parent / Guardian Signature is required for all participants under the age of 19. Participants 19 and older can sign for themselves.