Youth Leadership Permission Slip

I give
Name(Required)
permission to attend
with the NLBDC Youth Program.
I/We understand all reasonable safety precautions will be taken at all times by No Longer Bound Development Center and its agents during the events and activities. I/We authorize any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of an emergency. I/We understand the possibility of unforeseen hazards and know the inherent possibility of risk. I/We agree not to hold No Longer Bound Development Center Inc. its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form.
Parent/Guardian Name:(Required)
Please use your finger or mouse to sign below
Emergency Contact(Required)
Additional Emergency Contact
This field is for validation purposes and should be left unchanged.