PeacePlayers Chicago Programing
Please register for PeacePlayers Chicago programming below.  Currently, PeacePlayers is not open to the general public.  If you have not been invited to join PeacePlayers by one of our Partner Programs or you have questions, please reach out to David at dsmith@peaceplayers.org for more information.
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Privacy Notice
Information will be kept for contractual purposes,  to stay in touch about community relations and peace building through sport work that PeacePlayers does, for programmatic delivery and reporting purposes. This information will be recorded and stored for child protection and data analysis.

PeacePlayers Chicago will never sell this data and promises to keep details safe and secure.  You can change your mind at any time by emailing dsmith@peaceplayers.org.

For further details on how data is used and stored you can contact David Cassel at PeacePlayers International.
David Cassel, Co-Executive Director, US -- Phone: 1(708)250-4957 

Upon request,  PeacePlayers can send a copy of the organization’s Data Protection and Privacy Policy.
I understand and have received Privacy Notice
 *
Required
Food Allergy Notice
Please be advised that food served or prepared during our in-person and virtual programming may contain these ingredients:
milk, eggs, wheat, soybean, peanuts, tree nuts, fish, and shellfish.
I understand and have read the Food Allergy Notice
 *
Required
Do you have any food allergies? If Yes, please provide details below. If no, type N/A.
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Safeguarding Policy
We understand the importance of children being able to use the internet for education and personal development. This includes social media platforms, games and apps. We aim to support children and young people in making use of these in our work, especially as many situations have caused us to rely more heavily on virtual engagement. However, we also recognize that safeguards need to be in place to ensure children are kept safe at all times.

Young person’s agreement
• I will be responsible for my behavior when using the internet, including social media platforms and in-person/online meeting platforms. This includes the resources I access and the language I use.
• I will not send anyone material that could be considered threatening, bullying, offensive or illegal.
• I will be mindful of the things that I share with others such as personal information.
• I will be respectful of all members of the community including staff, coaches, and other participants.
• During programming, I will be engaged and any communication that I send will be appropriate and relevant to the discussion.

I understand that my internet use may be recorded and logged and can be made available to the PeacePlayers Staff. I understand that these rules are designed to keep me safe and that if I choose not to follow them, PeacePlayers may contact my parents/guardians.

I understand that virtual platforms will encourage photographic, video and media coverage to be shared and taken, of which I give permission for PeacePlayers and potential 3rd parties to use. This includes printed and electronic publications.
I have reviewed and agree to the Safeguarding Policy.
*Parent/ Guardian type digital signature: First and Last name
 *

WAIVER AND RELEASE OF LIABILITY

PLEASE READ CAREFULLY


I fully understand and accept that all PPI activities are undertaken at my child’s own risk and that by participating in PPI activities, I, on behalf of my child, hereby explicitly assume the risk of any injury, illness, or even death.  I represent and warrant that my child is in good health and physical condition, and I understand that no one at PPI has or will diagnose, examine or otherwise make a determination as to whether or to what extent my child should be participating in PPI activities or as to the effect or possible effect of any physical activity on my child’s health.

Being fully aware of the risks, conditions and hazards that my child may encounter while participating in PPI activities, I HEREBY WAIVE, RELEASE AND DISCHARGE, in advance, PeacePlayers International and its past, present and future subsidiaries, affiliates, successors, predecessors, executors, committees, fiduciaries, trustees, employee benefit plans, workers compensation carriers, plan administrators, administrators, partners, employees, insureds, assigns, agents, and representatives in their personal and professional capacities (collectively "PPI”), from any and all actions, causes of action, claims, damages, demands, injuries and liabilities of any nature whatsoever (including attorneys' fees, costs and interest) for personal injury or death arising out of or connected with my child’s participation in any and all PPI activities or events, regardless of whether such injury or damage was foreseeable, even though that liability may arise from negligence or carelessness on the part of PPI.  I further agree to accept all responsibility for the risks, conditions and hazards which may occur whether they now be known or unknown.

I further WAIVE, RELEASE AND DISCHARGE any right that I or my child may have to a claim for compensation against PPI, its past, present and future subsidiaries, affiliates, successors, predecessors, executors, committees, fiduciaries, trustees, employee benefit plans, workers compensation carriers, plan administrators, administrators, partners, employees, insureds, assigns, agents, and representatives in their personal and professional capacities. 

I HEREBY ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY AND/OR DEATH of my child due to negligence or otherwise while participating in PPI activities and events and further agree to forever HOLD HARMLESS and INDEMNIFY PPI, generally or specifically, from any and all actions, causes of action, claims, damages, demands, injuries and liabilities of any nature whatsoever (including attorneys' fees, costs and interest) for personal injury or death arising out of or in any manner connected with my child’s participation PPI activities or events, whether caused by negligence or otherwise.

I represent, understand, acknowledge, and agree that the foregoing Release and Waiver of Liability is intended to be as broad and inclusive as is permitted by the law.  If any portion of this Release and Waiver is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and effect.

I have READ AND VOLUNTARILY SIGN this Program Consent Form and Release and Waiver of Liability, and further agree that no oral representations, statements or inducements apart from the foregoing written agreement have been made.  This is the entire Agreement and any amendment to, modification of, or supplement to this Agreement must be in writing and signed by an expressly authorized representative of PPI.


I have reviewed the Waiver and Release of Liability Statement and agree.
*Parent/ Guardian type digital signature: First and Last name
 *
I affirm that I am the Parent/Guardian of the registering participant and have completed this form on their behalf: (Yes/No)
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Child's Name *
Child's Age *
How PeacePlayers Operates in the Gym
PeacePlayers is requiring all participants to understand, agree, and follow:

- RESPECT when speaking and listening to others
- RESPONSIBLE for my own behavior and actions
- NO BULLYING/THREATENING other participants
- NO HARASSMENT of ANY kind is allowed  
I understand, agree, and will follow the standards listed above?
 *
Required
Child's T-shirt Size *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Grade *
Child's Gender: *
Required
Race/Ethnicity *
Which PeacePlayers Partner Program does the Child attend: *
Home Address: *
City: *
Zip Code: *
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
Parent/Guardian Email: *
Emergency Contact Name: *
Emergency Contact Relation: *
Emergency Contact Number: *
Thank you for completing the registration!
You are registered for PeacePlayers Chicago Programming. Thank you so much for joining our PeacePlayers Community!
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