Youth United Parent Release Form

Name of Student

Student Email

Student Cell Phone

Mailing Address

City

State/Province

ZIP/Postal Code

Birth Year

School

Grade Fall 2026

Please list any health conditions or allergies that we should be aware of:

Name of Parent/Guardian

Company

Parent/Guardian Email

Parent/Guardian Phone

I give my permission for my child to participate as a Youth United volunteer as part of United Way of Northwest Georgia. I understand that without some program providing protection for its assets and its leaders, United Way of Northwest Georgia, a non-profit organization, would not be able to offer its community services and activities. Thus, I hereby release and waive all claims and suits against United Way of Northwest Georgia, its directors, employees, insurers, agents, representatives, assigns, sponsors, participating community service organizations, and other personnel or organization in any way assisting or connected with Youth United. I further agree to indemnify, defend and hold them harmless from any injury or loss associated with my child’s participation in Youth United volunteer activities. I acknowledge that there are certain foreseeable and unforeseeable risks associated with my child’s participation in Youth United volunteer activities. Accordingly, I expressly assume on my child’s behalf all risks associated with participating in these activities, including, but not limited to, illness, traveling to and from activities, contact with other volunteers or participants, the effects of the weather (including temperature extremes and humidity), all such risks being understood and appreciated by me. I hereby assign to United Way of Northwest Georgia all rights to video and audio recordings and all photographs of my child made in connection with Youth United volunteer activities. I hereby authorize editing, duplication, reproduction, copyright, exhibition, broadcast and/or other use and distribution of such recordings or quotations for purposes deemed suitable by United Way of Northwest Georgia. I also waive any right to approve or disapprove the finished products. I have read the foregoing Parental Permission, Waiver and Release Agreement before affixing my signature below, and warrant that I fully understand the contents thereof.

Yes, I understand.

Parent/Guardian Signature

Sign above

Youth United Parent Release Form

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