Day Camp Junior Leader Waiver Form PARENT/GUARDIAN: Please submit all info below. If you have any questions, please contact Christine Moss at email@example.com. Thanks! We look forward to working with your child at camp. 🙂Junior Leader - Name* First Last Junior Leader - Cell PhoneJunior Leader - Email* PARENT/GUARDIAN CONTACT INFORMATIONParent/Guardian - Name* First Last Parent/Guardian - Cell Phone*Parent/Guardian - Email* CONSENTSPARTICIPATION: I give permission for the youth in my care noted above, to participate as a Junior Leader in the Day Camp program set forth by Northumberland Youth Unlimited.* Yes No MEDICAL/HARM: I give permission for the person(s) in charge to seek medical assistance for the youth in my care noted above, in the event of accident or injury. Furthermore, I do not hold Northumberland Youth Unlimited or any of its subsidiary programs responsible for any harm that may occur to the youth in my care noted above, as a result of his/her wilful participation in the program.* Yes No TRANSPORTATION: If transportation is required, I give permission for the youth in my care noted above, to travel in a vehicle owned by Northumberland Youth Unlimited, or by its staff or volunteers, for the duration of the program. I understand that drivers and their vehicles are licensed and insured according to local, provincial and federal laws, insurance policies and NYU’s Policies & Procedures. Furthermore, I do not hold Northumberland Youth Unlimited responsible for any harm that may occur to the youth in my care noted above, as a result of his/her wilful participation in the transportation. Yes No PHOTO/VIDEO: I do authorize Northumberland Youth Unlimited to take, use and own, in perpetuity; names, photographs or video/audio recordings of the youth in my care noted above, understanding that these may be used for public promotional purpose. Northumberland Youth Unlimited does not sell or give away any recorded materials or mailing list information.* Yes No CommentsSIGNATURE: I acknowledge that clicking on the SUBMIT button below serves as my legal signature.CommentsThis field is for validation purposes and should be left unchanged.