Empowering Our Youth Through Action!

YFFL Ages 12-17

Entrant's Information

* A recent physical examination will be needed to play

Gender *

MaleFemale

Height *

Parent/Guardian's Information

AUTHORIZATION FOR MEDICAL RELEASE AND RELEASE OF LIABILITY

I authorize and give my consent to any emergency facility and physician to administer necessary treatment to my child. In the event of an emergency at which time I cannot be reached and/or time is of the essence, I give my consent to transport by ambulance if the situation warrants.

Also, by allowing my child to attend the activity, the undersigned recognizes and acknowledges that there are inherent dangers and risks in the activity, which dangers and risks the undersigned, on behalf of him/herself, as well as on behalf of the undersigned’s spouse, children, ward and others for whom the undersigned is legally responsible, hereby assumes. Consequently, it is understood and agreed that in consideration of my child being permitted to participate in the activity, the undersigned, on behalf of himself/herself, as well as on behalf of the undersigned’s children, ward and others for whom the undersigned is legally responsible, hereby releases, discharges, indemnifies and holds harmless the Young Adult Leadership & Development, YALD, their agents, employees, representatives, chaperones and volunteers, from any and ll claims, actions, demands, or damages whatsoever, in law or in equity (including attorney’s fees and costs incurred in connection therewith), and specifically including those arising as a result of any alleged negligence of the Young Adult Leadership & Development, YALD, their agents, employees, representatives, chaperones and volunteer, for any and all injury, damage or loss, to person or property, arising directly or indirectly from attending the activity or participating in any activities in connection therewith.

Also, upon agreeing with the terms,I hereby acknowledge that Photographs and digital images of the participants may be used for demonstrative or promotional purposes. I understand that I may contact YALD to exclude my child from the photos at anytime with writtent consent. The photos will be archived or destroyed by YALD after the image is no longer needed.

Finally, I am representing that I am legally authorized to bind, and am hereby binding myself, my spouse, children, ward and other for whom I the undersigned is legally responsible.

I Agree To The Terms