I, do hereby give my consent for my child to participate in all of the scheduled youth activities in the Why Try Youth Program and any other supervised activities associated with the youth program. Further, I certify that my youth is physically fit to participate in any of the mild to moderate recreational activities associated with the Why Try Youth Program.

I also understand that this program will feature content related to  mental health and discussions on other issues that impact youth today. I understand that I can revoke my consent at any time during the program and will contact the program leaders if and when I choose to withdraw my youth from the program.

I also understand that I will be contacted by phone in the case of a medical emergency. In the event that I cannot be reached, I authorized the calling of 911 for emergency dispatch, a doctor, or other emergency medical services in the event that my youth becomes injured or sick. I understand that the Why Try Youth Program's leader and facilitators will not be responsible for any medical expenses that are incurred solely on the basis of this authorization.

I further agree to notify the program leaders and facilitators of any health changes that would restrict my youth from participating in any of the program activities. I also understand that the program leader and facilitators have the right to restrict my youth from participation in any of the program activities if and when they feel the activity is not within the physical capabilities of my youth.