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Informed Consent and Acknowledgement of Risk

DISCLAIMER: This information is designed to provide accurate information with regard to the subject matter covered. However, Parent Booster USA cannot and does not provide legal services or information. The users of this information must determine for themselves, or with the assistance of a legal professional who can review all of your organizations circumstances, whether the information provided here is appropriate for their need. By using this information you are assuming all risks and liability for its use. If legal advice is required, the services of a competent professional should be sought.



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




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