Yo4Youth 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 {text-8} 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.

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 Name: {text-8}