mYnd pump Transportation Waiver & Release

Throughout the mYnd pump program, we have organized some fun off-site events and opportunities which will require transportation in a chartered school bus, Uber, Taxi or YMCA Van. These opportunities will include a variety of events that will be shared with you via email.

All such trips will take place during the evening of the program, hours may be altered depending on the event. Participants will be driven to and from the YMCA of Oakville to be picked up at the end of the program.

Participant Information

Participant’s Name *

First

Last

Parent/Guardian Name

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Last

Parent/Guardian if under 18 years old

Email Address *

Phone Number *

Participant Acknowledgement

Parent/Guardian if under 18 years old

I (and my legal guardian, where applicable) give my permission to be transported in a chartered school bus, Uber, taxi or YMCA van as needed for the YMCA of Oakville mYnd pump program and participate in off-site events.

I understand that by allowing the YMCA of Oakville to transport my child to/from the above-mentioned location/activity, I agree to release the YMCA of Oakville, its agents and employees, from and against any and all liability, loss, damages, claims or actions to the maximum extent permissible by law, arising out of such transportation.

By signing my name, I (and my legal guardian, where applicable) acknowledge that I (or we) have carefully read and understand this Form.

Participant Acknowledgement *

I agree that all information given on this application form is accurate to the best of my knowledge.

Participant/Parent/Guardian’s Signature *

Clear Signature

Participant/Parent/Guardian’s Full Name *

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Last