Hopefully you’re here because your child has been invited to YEP’s leadership training at Action City from 10:00-2:30 on Saturday, December 2nd, 2023. Our plan is for about 2 hours of leadership focused training, followed by lunch, and then fun time.
If you recently filled out a form for our Action City day on November 11th, this is the same basic paperwork, but it’s required for all of our outside of school events. The good news is we don’t have any more planned until June, so it will be awhile before we ask you to sign one again!
In order for students to attend, a parent or guardian must complete this form. We have a limited number of seats for this training, so if your child is no longer interested or unable to go, please let us know (email [email protected]) so we can invite other students from our waiting list.
Required Form for Parents/Guardians Starts Here
Agreement for Assumption of Risk, Indemnification, Release, and Consent for Emergency Treatment
I understand that I am being asked to read each of the following paragraphs carefully. I understand that if I wish to discuss any of the terms contained in this agreement, I may contact Arbor Place, Inc. Manager of Prevention Services, Sherry Berg at 715-235-4537 Extension 220 or [email protected]
Assumption of Risk: I understand that not all risks can be foreseen and there are some risks which are unpredictable. I understand that certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I am aware that all care will be taken by Arbor Place, Inc. staff to reduce the possibility of risk, but that participation in the Youth Empowerment Program activities and events may involve some inherent risks. I understand that no coverage for health and accident insurance is provided for my child by Arbor Place, Inc. I know, understand, and appreciate the risks that are inherent in the above listed programs and activities. I hereby assert that my child’s participation is voluntary and I knowingly assume all such risks.
Hold Harmless, Indemnity and Release: In consideration of my participation in these activities, I, for myself, spouse, heirs, personal representatives, estate or assigns, agree to defend, hold harmless, indemnify and release, Arbor Place, Inc. and their officers, employees, agents and volunteers who are involved, from and against any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, or personal injury, or death which may result from my participation in the above-listed program. This release includes claims based on the negligence of Arbor Place, Inc. and their officers, employees, agents and volunteers, but expressly does not include claims based on their intentional misconduct or gross negligence. I understand that by agreeing to this clause I am releasing claims and giving up substantial rights, including my right to sue.
Consent for Emergency Treatment: I authorize Arbor Place, Inc., and their designated staff to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.