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Youth Volunteer Waiver

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Youth Waiver & Consent Form
For Participation In All NEXT Steps YEP
Activities & Opportunities

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All volunteers under the age of 18 must submit a signed Youth Volunteer Waiver before they can participate in any NEXT Steps volunteer opportunity.

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YOUTH WAIVER
This Youth Waiver must be signed by a parent, legal guardian or other consenting adult and is REQUIRED from all participants under the age of 18.

This waiver serves as my consent and grants permission for my child to participate in the following youth development event of The NEXT Steps Youth Entrepreneur Program. In connection with my child or ward’s voluntary involvement in activities undertaken for, and with the participation and support of The NEXT Steps Youth Entrepreneur Program, a non-profit charitable organization, I hereby agree, for myself, my heirs, assigns, executors and administrators to release and discharge The NEXT Steps Youth Entrepreneur Program, and any partnering agency or school, its officers and directors, employees, agents and volunteers from all claims, demands and actions for injuries sustained to my child or ward’s person and/or property as a result of his/her involvement in such activities, whether or not resulting from negligence, and I agree to release and hold The NEXT Steps Youth Entrepreneur Program, and any partnering agency or school, its officers and directors, employees, agents and volunteers harmless from any cause or action, claim or suit arising therewith. I hereby attest that attendance and involvement in such activities is voluntary, that he/she is participating at his/her own risk, and that I have read the foregoing terms and conditions of this release. Furthermore, I grant permission for photographs, video and quotations from my child or ward during his/her involvement with The NEXT Steps Youth Entrepreneur Program to be used to further promote volunteerism.

Permission:
I hereby give permission to my child or ward to participate in the activities of The NEXT Steps Youth Entrepreneur Program expressly and specifically acknowledging that those activities may include, but may not be limited to outdoor activities including gardening, painting and planting and/or field trips and bus transportation to and from the event site. I further acknowledge the risk of physical injury or damage to property as a result of my child’s participation in the activities. I also give The NEXT Steps Youth Entrepreneur Program permission to take my child or ward to the hospital in case of any emergency and to administer medication that I provide for my child. My child is capable of participating in these activities. I further attest that my child or ward has no allergies or special medical needs other than those listed below:
Student Information
First Name*
Middle Name
Last Name*
Date Of Birth
MM slash DD slash YYYY
Current Grade*
Ethnicity
Please check all that apply.
- African American/African Heritage
- Asian Heritage/Pacific Islander
- Caucasian/European Heritage
- Hispanic/Latin Heritage
- Native American Heritage
- Other Heritage
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Instagram
Twitter
Facebook
Snapchat
School/Organization Name & Address
School/Organization Name Schoo/Organization Address City State / Province / Region ZIP / Postal Code Country
Homeroom Teacher/Counselor
Homeroom Teacher/Counselor Phone
Homeroom Teacher/Counselor Email
Event Information
Event Name*
Event Date*
MM slash DD slash YYYY
Event Location*
Enter as much information as possible.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian/Adult Information
Name
Prefix First Middle Last Suffix
Adult Phone
Adult Email
As the person filling out this Youth Consent form, what is your relationship to the applicant?
- Parent
- Grandparent
- Legal Guardian
- Counselor
- Group Leader
Adult Consent & Electronic Signature*
I agree to electronically sign this Youth Waiver and registration form on behalf of the applicant who is under the age of 18. Typing my name below represent my consent and signature.
Today's Date
MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

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