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Youth's Name  

IN CONSIDERATION of the right to attend and participate in , the parent/guardian of the above-identified youth hereby:

1. Authorizes and gives the youth permission to participate in the event;
2. Understands that the event will include: [INSERT DETAILED DESCRIPTION OF EVENT AND THE RISKS INVOLVED ….MORE DETAIL IS BETTER SO THAT PARENTS KNOW EXACTLY WHAT THEY ARE CONSENTING TO]
3. Acknowledges that there is an element of risk involved in any activity involving [INSERT BASIC ACTIVITIES INVOLVED, I.E. OUTDOOR ATHLETIC ACTIVITIES, ETC.] and parent assumesall risk of and financial responsibility for any loss or injury to the participant or others that may occur as a result of the participant’s negligence or misconduct; and indemnifies and holds the [PARENT ORGANIZATION NAME] harmless from and against any and all costs, claims, demands, charges, liabilities, obligations, judgments, executions, costs of suit and actual attorneys’ fees incurred or suffered by the [PARENT ORGANIZATION NAME] as a result of, or arising out of, the participant’s negligence or misconduct; and
4. Authorizes [PARENT ORGANIZATION NAME] to obtain or authorize any reasonable incidental and/or emergency medical treatment for the participant in the event the participant’s parent(s)/guardian(s) are not readily located and participant becomes ill, injured or incapacitated; parent(s)/guardian(s) hereby accept the responsibility to pay for such treatment.
   This Informed Consent and Acknowledgement of Risk may not be amended, supplemented or abrogated without the written consent of [PARENT ORGANIZATION NAME].
   
   The parent(s)/guardian(s) signing below on behalf of participant acknowledge that they have read this consent and understand its contents.

Name of parent(s)/guardian(s) – printed

Signature of parent(s)/guardian(s)

Contact #

Date