I give permission for my child to participate in A Universe of Stories! Summer Reading Program sponsored by the American Samoa BYU Alumni Chapter (ASBYU) and the Feleti Barstow Public Library (FBPL).

Liability Release and Parental Consent Form: In consideration of the acceptance of my application for the above program, I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to me as a result of participation in said event. This release is intended to discharge in advance ASBYU, FBPL, American Samoa Community College (ASCC), and the Church of Jesus Christ of Latter-day Saints, its officials, officers, employees, volunteers and agents from liability, even though that liability may arise out of perceived negligence on the part of persons mentioned above. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees.

Consent for Treatment: I hereby give my consent to have the above applicant treated by emergency medical personnel, a physician, or surgeon, in case of sudden illness or injury while participating in the above activity. It is understood that ASBYU, FBPL, ASCC, and the Church of Jesus Christ of Latter-day Saints will provide no medical insurance for such treatment, and that the cost thereof will be at my expense.

I authorize ASBYU to publish the photographs taken of me and/or my registered child, and our names, for use on the BYU Alumni website, social media platforms, and for display in the FBPL. I release ASBYU from any expectation of confidentiality for my registered child and myself and attest that I am the parent or legal guardian of the child registered here and that I have the authority to authorize ASBYU to use their photographs and names. I acknowledge that since participation in publications and websites produced by ASBYU is voluntary, neither my registered child nor I will receive financial compensation. I further agree that participation in any publication and website produced by ASBYU confers no rights of ownership whatsoever. I release ASBYU, its affiliates and its members from liability for any claims by me or any third party in connection with my participation or the participation of my registered child.