Power Up with Trades
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Participant name *
School *
Grade *
Parent/guardian email address *
Student email address *optional*

Emergency contact person *
Emergency contact phone number  *
Do you have any existing medical conditions or special needs which would affect your ability to participate and/or require extra supports?

Please describe so we can best support you.
*
Do you have any allergies?
What are they and what is the severity? 

*
LIABILITY & MEDICAL RELEASE
 I hereby agree to release Yukon Women in Trades and Technology (hereafter referred to as " the organizers ”), YuKonstruct, it's representatives, agents, servants, volunteers, and employees from liability for any injury to the named person, resulting from any cause whatsoever occurring to the
named person at any time while attending POWER UP!, including travel to and from these
activities, excepting only such injury or damage resulting from willful acts of such representatives, agents, servants, and employees
I do voluntarily authorize the organizers, their representatives, agents, servants, volunteers, and employees to obtain routine or emergency diagnostic procedures and / or routine emergency medical treatment for the named person as deemed necessary in medical judgment
I agree to indemnify and hold harmless the organizers, their representatives, agents, servants, volunteers, and employees for any and all claims, demands, actions, rights of actions, and / or judgment by or on behalf of the named person arising from or on account of said procedures and / or treatment rendered in good faith and according to accepted medical standards
ASSUMPTION OF RISK: I hereby acknowledge that there are inherent risks, dangers and hazards when participating in activities held at or sponsored by Yukonstruct Society, including the use of various tools associated with design, experimentation, fabrication, construction and other related activities I understand that participation in such activities and the use of such equipment may result in injury, illness, death or damage to personal property These risks and dangers may be caused by other participants, or by accidents, acts of nature or other causes Risks and dangers may arise from foreseeable or unforeseeable causes and may include, but are not limited to: electrocution, burns, impalement, injury from slips or falls, etc.
RELEASE OF LIABILITY: I hereby release Yukon Women in Trades and Yukonstruct Society and its members, officers, agents, and board members from any action whatsoever arising out of any damage, loss or injury to the named participant or their property while upon the premises, or while using any equipment of the organization or others, or while participating in any of the activities contemplated by this agreement ; whether such loss, damage, or injury results from the negligence of the corporation, its members, agents, or from some other cause
COVENANT NOT TO SUE: I hereby agree never to institute any suit or action at law otherwise against Yukon Women in Trades and Technology and Yukonstruct Society, its members, officers, agents or board members ; nor to initiate or in any way assist the prosecution of any claim for damages or course of action which myself, my heirs, my executors or my administrators hereafter may have by reason of injury to the named participant or to their my property arising from the activities contemplated by this agreement
THIRD PARTY INDEMNIFICATION: I hereby agree to indemnify, save and hold harmless Yukonstruct Society, its members, officers, board members, or agents from any and all losses, claims, actions, or proceedings of every kind and character which may be presented or initiated by
any other persons or organizations and which arise directly or indirectly from the named participant's actions while engaged in the activities contemplated by this agreement
I agree to the  LIABILITY & MEDICAL RELEASE *
Photo Release
I agree that still photographs and videotapes of the named participant taken during the course of the POWER UP ! workshops may be used and reproduced by the organizers and their assigns and licensees from any liability in relation to using my image including claims for either invasion of privacy or libel
I agree to the Photo Release *
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