Parent/Guardian Permission Form

 

Step 1

Parental/Guardian consent is required for participation in Youthentity’s Career Academy & YE University. By agreeing to the statements and submitting the form below, you confirm that parental/guardian consent has been given for participation in Youthentity programs.

YOUTHENTITY PARENT/GUARDIAN PERMISSION TO PARTICIPATE & ACKNOWLEDGMENT OF RISK:

I hereby give permission for my child to participate in the Youthentity program and occasional field trips that may be offered with advance parental written permission. I am aware that it is not possible to foresee and prevent all potential losses arising from indoor and outdoor activities. Knowing the risks and dangers, I understand the possible consequences of my child participating in activities during program participation. By signing below, I hereby agree to allow my child to participate in all activities with full knowledge that there are real risks of loss inherent in it. By signing below I expressly assume on behalf of my child all risk of injury associated with participation in program activities. I hereby give my consent for any emergency anesthesia, surgery, hospitalization or other medical treatments that might become necessary for my child. As my child’s parent or legal guardian, I hereby agree to take full financial responsibility for any such care. I hereby state that to the best of my knowledge, my child has the necessary mental and physical skills and ability to participate in the activity. As the child’s parent or guardian, I assume full responsibility for my child for bodily injury and loss of personal property and expenses thereof.

I understand that my child will be required to follow instructions and abide by the program rules and reasonable safety procedures. I understand that Youthentity reserves the right to refuse to allow my child to participate in part or all of the activities if they are determined to be incapable of participating safely. Youthentity also reserves the right to expel students due to behavioral concerns. I grant Youthentity permission to communicate with Roaring Fork School District employees about student performance and behavior during Youthentity programs.

As further consideration for my child’s participation in this program, I (for myself and my spouse {if any} and on behalf of my child) do hereby fully and forever waive and release Youthentity from each and every claim, suit, action or cause of action of any kind or nature that may arise or be assertable in any way whatsoever relating to my child’s participation in this program, and further, I shall fully and forever defend, indemnify and hold harmless Youthentity from and against any and all claims, demands, losses, liabilities, damages, actions, causes of action, suits, judgments, costs and expenses (including court costs and attorneys’ fees) in any way whatsoever arising out of or relating to my child’s participation in this event.

I have read, understood and accepted the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon my child & me during the entire period of participation in the program.

I agree to the above statements concerning my child's participation and involvement in Youthentity programs. *
Student Name *
Student Name
Parent/Guardian Name *
Parent/Guardian Name
Date *
Date
Parent/Guardian Phone Number *
Parent/Guardian Phone Number
Bus Pass *
Youthentity Provides RFTA Bus Passes free of charge for students to get too and from their classes.
Chef's Jackets are Unisex
One Name Only
Please indicate gender and size

 

Step 2

 
 

Step 3

Provide further details about yourself (emergency contacts, date of birth, school, ethnicity, allergies, etc.)

 

Provide further details about yourself (emergency contacts, date of birth, school, ethnicity, allergies, etc.)

Student Name *
Student Name
Student Phone *
Student Phone
Home Address *
Home Address
Gender
Ethnicity
Date of Birth *
Date of Birth
Parent/Guardian Info
1st Parent Guardian Name *
1st Parent Guardian Name
1st Parent/Guardian Phone: HOME/CELL *
1st Parent/Guardian Phone: HOME/CELL
1st Parent/Guardian Phone: WORK
1st Parent/Guardian Phone: WORK
2nd Parent/Guardian Phone: HOME/CELL *
2nd Parent/Guardian Phone: HOME/CELL
2nd Parent/Guardian Phone: WORK
2nd Parent/Guardian Phone: WORK
Emergency Contacts (if different from Parent/Guardian)
Emergency Contact #1 - Name
Emergency Contact #1 - Name
Emergency Contact #1 - Phone
Emergency Contact #1 - Phone
Emergency Contact #2 - Name
Emergency Contact #2 - Name
Emergency Contact #2 - Phone
Emergency Contact #2 - Phone
Photo Release
Photos may be taken of students and used in school displays, handouts, and educational and promotional materials that include print, digital and video mediums. May Youthentity use photos of your child for these purposes?
Photo Release *
Allergies
 
 

Submit payment for Career Academy. Tuition of $200 includes all class materials.

If you need financial assistance with the tuition please reach out to Youthentity directly at 970.963.4055