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YLMA — Permission Slip & Liability Waiver
Youth Leader & Mentorship Academy
Building Christian Leaders for Youth Organizations

Off-Grounds Activity — Permission Slip & Liability Waiver

Leader completes Sections 1 & 7, then forwards the link to parents/guardians to fill out Sections 2–6 and submit.

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Leader Mode: Fill in the activity details (Section 1) and your return instructions (Section 7), then use the Forward button at the bottom to send parents their personalised form link.
1
Activity Information
Leader completes — will be pre-filled for parents
Leader Only

Fields marked ★ are required.

7
Return & Submission Instructions
Shown to parents — submissions email directly to you
Leader Only

📤 Forward Form to Parent(s) / Guardian(s)

Add one or more parent/guardian email addresses. Each recipient receives a personalised link pre-filled with your activity details — they complete Sections 2–6 and submit directly to you.

How it works: Each parent gets a unique link. They fill in participant info, medical details, permissions, and sign the waiver — their completed PDF is emailed directly to you.
✅ Email client opened — please send to all recipients!
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Parent / Guardian: Activity information has been pre-filled by your leader. Complete Sections 2–6, sign the waiver, and click Submit — your form goes directly to your leader.
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Fields marked ★ must be completed. All five acknowledgement boxes must be checked. Submit before the deadline shown in Section 7.
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Current / Returning Member? Skip the Paperwork.

Returning Members

If your child is an active, enrolled member and you have already completed the organization's enrollment form with your current contact, medical, and permission information — you may confirm that all information on file remains accurate instead of re-entering it below.

Typed name constitutes a legal electronic signature confirming your enrollment form data remains accurate.
Note any information that has changed since you last submitted the enrollment form.
✅ Returning Member Confirmed. Sections 2–5 below are on file and have been skipped. Please scroll down to Section 6 to review the waiver terms and complete the activity-specific permission signature, then submit your form.
1
Activity Information
Pre-filled by your leader — read only
Pre-Filled
Will be filled by your leader
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2
Participant Information
Youth attending this activity
Parent Fills

Fields marked ★ are required.

3
Parent / Guardian Information
Contact and pickup authorization
Parent Fills
Primary Parent / Guardian
Secondary Guardian (if applicable)
Emergency Contact (other than parents listed above)
Authorized Pickup Person(s) (other than guardians)
4
Medical Information
Kept strictly confidential
Parent Fills
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Health & Medical Details — This information is kept strictly confidential and used only in the event of a medical situation during the activity.
5
Photo & Video Permission
Media release for this activity
Parent Fills

Photos and videos taken during this activity may be used in newsletters, social media, and program materials. Please select your preferences below.

6
Waiver & Release of Liability
Read fully before signing
Parent Signs

Participation & Release of Liability

I/We, the undersigned parent(s) or legal guardian(s), hereby grant permission for the above-named participant to attend the off-grounds activity described above. I/We understand that participation may involve physical activity, travel, and inherent risks of injury or illness, and I/We voluntarily assume all such risks. I/We release, discharge, and hold harmless the organization, its officers, directors, staff, volunteers, and agents from any and all claims, liabilities, demands, or causes of action arising from participation, whether caused by negligence or otherwise.

Medical Authorization

I/We authorize designated leaders and staff to consent to any necessary emergency medical, surgical, or dental treatment for the participant in the event I/We cannot be reached in a timely manner. I/We agree to assume responsibility for all medical costs incurred. Every reasonable effort will be made to contact a parent or guardian before seeking emergency treatment.

Transportation Authorization

I/We grant permission for the participant to travel via the mode of transportation specified for this activity to and from the activity location. I/We acknowledge the organization's transportation guidelines and trust designated drivers and chaperones to exercise reasonable care.

Code of Conduct

I/We understand that participants are expected to conduct themselves respectfully toward all leaders, chaperones, and fellow participants at all times. Disruptive, disrespectful, or dangerous behavior may result in removal from the activity and return to a parent or guardian at the family's expense. I/We agree to support the enforcement of behavioral standards.

Photo & Media Release

I/We acknowledge the photo and video permissions selected in Section 5 of this form. Permissions may be revoked at any time by providing written notice to the organization. Images and recordings will be used solely for organizational and program-related purposes.

Accuracy of Information

I/We certify that all medical, contact, and personal information provided in this form is accurate and complete to the best of my/our knowledge. I/We agree to notify the organization of any changes prior to the activity date. This form constitutes the entire agreement regarding this activity and by signing I/We agree to be bound by its terms.

Please check each box to confirm your acknowledgement:

Typed name constitutes a legal electronic signature
7
Return & Submission Instructions
Your completed form will be sent to your leader
Pre-Filled
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Ready to submit? Your completed permission slip will be downloaded as a PDF and your email client will open to send it directly to your group leader.

✓ Permission slip submitted — check your email client!
⚠ Please complete all required fields, check all acknowledgements, and sign the waiver.