I/we, the parent(s)/guardian(s) of the child/children listed above understand that the Boys & Girls Clubs of the Pee Dee Area, Inc. makes available organized educational and recreational activities for its’ members. I/we understand that there are always dangers and risks connected in participation in such activities (particularly athletics) and, as Parents/Guardians of the child named above, I/we hereby give my/our approval of his/her participation in all activities of the club. I/we understand that responsibility for any and all such risks and dangers (including any risks associated with the transportation to or from the Club or any club activity) and I/we do hereby release, indemnify and hold harmless the Boys & Girls Clubs of the Pee Dee Area, Inc. and Boys & Girls Clubs of America, the organizers, sponsors, supervisors and staff of all its’ activities, from any and all liability in connection with any injury (including any injury caused by their own negligence) to the child named above. I/we likewise release and hold harmless from liability any person transporting him/her to or from any club activity.
I/we agree to adhere to the policies and procedures of the Boys & Girls Clubs of the Pee Dee Area, Inc. which are in place for staff, youth, parents, and visitors.
I/we understand it is my/our responsibility to insure my/our child adheres to the club rules and follows staff instructions. Inappropriate behavior, not following rules and staff instructions can result in my child’s suspension or expulsion from the Club. If suspended or expelled, I agree to pick up my child immediately from the Club. I also understand any fees paid will not be refunded if my child is suspended or expelled.
I/we agree to be financially responsible for any property damage or loss caused by my child from inappropriate behavior.
I/we understand that the Boys & Girls Club has a non-refundable membership fee.
I/we understand a late fee of $5.00 every 15 minutes will be charged for any child left after the club closes and this fee must be paid before a child returns to the club.
I/we understand my/our child’s successful participation at the Club can be enhanced with my active participation at the Club. If I have a question, concern or comment about the Club or my child’s behavior I will direct my question to the Club’s director.
I give my permission to Boys & Girls Clubs of the Pee Dee Area and my child's school or respective School District to exchange information regarding the minor child(ren) listed on this application. The purpose of the exchange is to help both organizations do a better job of helping the student succeed in school, in Boys & Girls Club, and in life. This release is valid for one year and may be revoked at any time by contacting the School District or Boys & Girls Club in writing.