Release of Liability: On behalf of my child (student named on this application), I do hereby agree and consent to my child’s participation in YWCA National Capital Area programs and do assume all risks and hazards which are part of the conduct associated activities. I hereby release, absolve, indemnify, and hold blameless YWCA National Capital Area, their officers, directors, employees, contracted employees, independent contractors, instructors, agents, organizers, and volunteers of any and all liability for damage, injury, or expense of any kind arising out of or connected with my child’s participation in YWCA EmpowerGirls Program. I understand that in case of a medical emergency, my own personal medical plan will be used. As a condition of participation in the YWCA programming by the student named in this application, I acknowledge that I have read this consent form, and knowingly, on behalf of my child, assume all of the risks associated with participating in any way in YWCA programming. I hereby release, to the fullest extent permitted by law, the YWCA National Capital Area and their affiliates, from any and all actions, claims, demands, or liabilities that I, my assignees, heirs, distributes, guardians, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from child’s participation in these activities irrespective of whether the same is based on breach of warranty, negligence, strict liability or any other theory or recovery. I have read and agreed to the program evaluation, release of information, and release of liability. I give my permission for my child to participate in the YWCA EmpowerGirls Youth Mentoring & Leadership Program. I agree that I have legal authority to sign this form on behalf of my minor child: Parent Name (Signature): Date: (Please Insert Below) *
