Parent Consent Form

To be completed by parent/ guardian

Name of parent/ guardian: ______________________________

Name of Applicant: ____________________________________________

Signature:______________________________ Date:________________________

Release of Liability
I do hereby release Youth With A Mission, Inc., its agents, employees, and volunteer assistants from any liability whatsoever arising out of any injury, damage or loss which may be sustained by my child during his/her course of involvements with Youth With A Mission.

Acknowledgement of Financial Responsibility
I confirm that I understand payment of my child’s required school tuition and fees must be made on or before his or her arrival, unless otherwise arranged with leadership, and I agree to make the necessary payments. I therefore accept all responsibility for any fees, tuition and personal expenses incurred by my child during his/her involvement with Youth With A Mission, Inc.

Consent for Treatment
In the event of an emergency in which my child is rendered unconscious and I cannot be contacted, I hereby agree to such treatment, anaesthetics and operations to be performed upon my child as deemed necessary in the opinion of the attending physician/s.