Student YFC Consent Form

STUDENT YFC CONSENT FORM

Student Information

Parent / Guardian Information (if student is minor)

Emergency Contact & Medical Information

I authorize designated YFC staff or volunteers to administer the following medication(s) listed above during program activities when deemed necessary: Yes No

Event / Activity Details

Activity / Program Name:

Event Date(s):     Location:

Authorizations & Release

In consideration of my child/student's participation in YFC activities, I hereby grant permission for participation and acknowledge the inherent risks of travel, recreation, and group activities. I authorize YFC staff and authorized volunteers to provide or obtain emergency medical care for the student if I cannot be reached. I agree to indemnify and hold harmless YFC, its staff, volunteers, agents, and affiliated organizations from any liability, claims, demands or causes of action relating to injury, loss, or damage arising from the student's participation, except where caused by gross negligence or willful misconduct.

I authorize licensed medical personnel to administer necessary treatment, including hospitalization and anesthesia, as determined by such personnel. I understand that I am financially responsible for all medical, transportation, and related expenses incurred on behalf of the student.

Discipline and Safety: The student agrees to abide by the rules and direction of YFC leaders. YFC reserves the right to remove a student from an activity for safety or conduct reasons; the undersigned agrees to be responsible for transportation costs and any additional expenses required to return the student home.

Photo/Media Release: I consent do not consent to the use of photographs, video, or audio recordings of the student for YFC promotional, educational, or archival purposes. I understand no compensation is provided for such use.

Transportation: I authorize YFC to provide or arrange transportation, including private vehicle transport by volunteers, buses, or other third-party carriers, for program activities and related travel. I understand that YFC maintains reasonable safety standards for transportation.

Data Use & Confidentiality: The information provided is true and accurate to the best of my knowledge and may be used by YFC for health and safety purposes, emergency contact, and administrative needs. Medical information will be shared only with personnel who have a need to know for the safety of the student.

Consent Selection (check all that apply)

I authorize the student to participate in all scheduled YFC activities and programs.

I authorize transportation by YFC staff/volunteers and approved carriers.

I authorize emergency medical treatment if parent/guardian cannot be reached.

I authorize use of photographs/video of the student for internal and promotional purposes.

I authorize overnight stays or extended trips as part of the program, when applicable.

Additional Instructions or Limitations

Acknowledgment and Signature

I certify that I am the parent or legal guardian of the student named above, or I am the student and at least 18 years of age, and that I have the legal authority to execute this Consent Form. I have read and understand the terms of this Consent Form, and I agree to the authorizations, releases, and acknowledgments contained herein.

Sign Now