Surrey School District Program - Tamanawis

CONSENT, CONFIDENTIALITY and ACKNOWLEDGEMENT OF RISK

Accidents can result when youth participate in activities and can occur with or without any fault on either the part of the participant, School or its employees or agents, or the facility where the activity is taking place.  By allowing my child (the Youth) to participate in the Yo Bro | Yo Girl Youth Initiative (YBYG) Program (Program), I, the Parent/Guardian (s) am (are) accepting the risk of an accident occurring, and agree that the Program, is suitable for my child.

By signing the Consent, I, the PARENT/GUARDIAN confirm that I:

1. have read and agree that the Program and activities are appropriate for the Youth and hereby provide consent for the Youth to participate in the activities;
2. have represented to YBYG that the Youth is medically fit to participate in the Program and related activities, and have informed the Youth not to participate further if he/she/they feel anything to be unsafe;
3. hereby agree that the Youth will not attend the Program or related activities if he/she/they is ill, including, but not limited to, symptoms associated with any respiratory disease (e.g., the common cold, allergies or COVID-19);
4. hereby give my permission for the Youth to consume drink and food items provided during the Program and related activities;
5. agree that I shall pay any and all financial obligations, loss or claims for compensation that YBYG may suffer or incur in any way as a result of the Youth's participation in the Program and related activities;
6. hereby waive any and all legal rights that I may have now or in the future and release from liability and agree not to sue YBYG for any loss or damage that I may suffer as a result of the Youth's participation in the Program and related activities;
7. hereby recognize that releasing YBYG from liability prevents me from claiming for money from YBYG;
8. have discussed with the Youth my expectations, YBYG’s expectations, and the risks and consequences if he/she/they does (do) not follow guidelines stated by the YBYG staff, and that I accept and assume all these risks and the consequences and freely choose to permit the Youth to participate in the Program and related activities regardless;
9. hereby agree that it is my responsibility to arrange insurance to cover any loss or damage the Youth may suffer, or liability that may incur, as a result of the Youth's participation in the Program and related activities;
10. understand it is my right to obtain as much information as required about the Program and activities and associated risks and hazards, including information beyond that provided to by the school or program;
11. recognize that YBYG may wish to promote my child’s positive interactions, accomplishments, photographs, and video on YBYG’s media, including without limitation, the YBYG website, emails, social media, and printed or digital promotional materials (“YBYG Media”);
12. acknowledge that YBYG and Surrey School District consents and written communication will be stored and shared between YBYG and Surrey School District in an online repository. Once participants such as my child are in the Program, communications will be conducted via phone, other online platforms or in person;
13. acknowledge that YBYG preserves the confidentiality of youth and families except when required by law, continuity of care, or the child’s and family’s safety.

I hereby give {name-1} {name-2} permission to participate in the Program and related activities and accept the level of supervision for the Program.

PARENT/GUARDIAN CONTACT INFORMATION:
by signing the consent, the parent/guardian agrees to all the policies stated in the permission package.

INFORMED CONSENT AND RELEASE OF LIABILITY
To Be Completed For High Risk Activities

Surrey School District Program - Senator Reid

To: The Board of Education of School District No. 36 (Surrey) and its officials, employees, teachers and agents (collectively and individually, the "Board")

STUDENT:

In consideration of the Board permitting me to participate in the Activity,

I, {name-1} {name-2} state as follows:

1. I have discussed with my parent(s)/guardian their expectations, and the Board's expectations, of my behaviour during the Activity.

2. I understand and agree to abide by the School's Code of Conduct and any other rules that are set out for this Activity.

3. I agree to cooperate with, and follow the directions given to me by, any of the Activity's supervisors for the entire duration of the Activity.

4. I have discussed with my parent(s)/guardian the significance of the declaration I am making by signing below.

PARENT(S)/GUARDIAN:

I, {name-4}, am the parent(s)/guardian of the Student. In consideration of the Board permitting the Student to participate in the Activity, I agree as follows:

1. I have read and understand the materials provided to me by the Board outlining the Activity and agree the Activity is appropriate for the Student. I hereby give my consent for the Student to participate in the Activity.

2. I represent to the Board that the Student is medically fit to participate in the Activity. I have informed the Student not to participate further if he/she feels anything to be unsafe.

3. I hereby agree that I shall pay any and all financial obligations, loss or claims for compensation that the Board may suffer or incur in any way as a result of the Student's participation in the Activity.

4. I hereby waive any and all legal rights that I may have now or in the future and release from liability and agree not to sue the Board for any loss or damage that I may suffer as a result of the Student's participation in the Activity.

5. I recognize releasing the Board from liability prevents me from claiming for money from the Board.

6. I represent that I have discussed with the Student my expectations, the Board's expectations, and the risks and consequences of injury. I accept and assume all these risks and the consequences and freely choose to permit the Student to participate in the Activity regardless.

7. I hereby agree that it is my responsibility to arrange insurance to cover any loss or damage the Student may suffer, or liability I may incur, as a result of the Student's participation in the Activity.

Media/website consent form

News Media

Over the course of a school year, the Surrey School District sometimes receives requests from the news media to interview, photograph or videotape individual or groups of students in connection with stories the media are working on. Also, the news media is sometimes invited to school functions to publicize events.

As a public body, we attempt to cooperate with the media whenever possible. However, your right to personal privacy is our priority. Therefore, we ask that this consent form be signed and returned to the school so we can respect your wish for family privacy.

(School staff cannot control news media access or photos/videos at public locations (e.g. field trips) or school events open to the public, such as sports tournaments, student performances, school board meetings, etc.)

School/District Websites

In accordance with the Freedom of Information and Protection of Privacy Act, the Surrey School District requires consent to use a students' full name or photograph/video on school or district websites accessible to the general public. Therefore, your permission is requested to post your child's full name, photograph or video of your child in connection with positive, day-to-day school activities or personal accomplishments.

(Consent for secondary school students is valid until graduation. Consent for elementary students is renewed annually. However, you may resubmit a new consent form to your school at any time to change your consent.)

Student's Name: {name-1} {name-2}