📅 SayPro Monthly January SCDR-4
📅 SayPro Quarterly Technology and Gaming Camps
🏢 By SayPro Camps Office under SayPro Development Royalty SCDR
Purpose of the Form:
The SayPro Parental Consent and Waiver Form is designed to ensure that participants under the age of 18 have the necessary parental or guardian consent to attend the SayPro Technology and Gaming Camps. This form also provides the SayPro Camps Office with emergency contact details and ensures that the terms and conditions are understood and agreed upon. By signing this form, the parent or guardian acknowledges their consent for the child to participate in the camp and accepts liability waivers associated with the activities.
Form Sections:
1. Participant Information:
- Full Name of Participant:
- [First Name] [Last Name]
- Date of Birth:
- [DD/MM/YYYY]
- Age of Participant:
- [Age]
- (Note: Must be under 18 to require parental consent)
- Gender (Optional):
- [Male/Female/Other]
2. Parent/Guardian Information:
- Full Name of Parent/Guardian:
- [First Name] [Last Name]
- Relationship to Participant:
- [Mother/Father/Guardian/Other]
- Primary Contact Number:
- [Phone Number]
- Email Address:
- [Email Address]
- Secondary Contact Number (Emergency):
- [Phone Number]
- Home Address:
- [Street Address]
- [City, State, ZIP Code]
3. Emergency Contact Information:
- Emergency Contact Name:
- [First Name] [Last Name]
- Relationship to Participant:
- [Relation, e.g., Aunt, Uncle, Friend]
- Emergency Contact Phone Number:
- [Phone Number]
- Alternative Emergency Contact Phone Number:
- [Phone Number]
4. Medical Information and Emergency Treatment Authorization:
- Does the Participant have any medical conditions, allergies, or special needs?
- [Yes/No]
- If yes, please specify:
- [Details of medical conditions/allergies]
- Is the participant currently taking any medication?
- [Yes/No]
- If yes, please specify:
- [Details of medication and dosage]
- Consent for Emergency Treatment:
- I authorize the camp organizers to provide necessary emergency medical treatment to my child in the event of illness or injury during the camp.
- [Yes/No]
- I authorize the camp organizers to provide necessary emergency medical treatment to my child in the event of illness or injury during the camp.
5. Consent for Participation:
- Participation Consent:
- I, the undersigned parent/guardian, hereby consent to my child’s participation in the SayPro Technology and Gaming Camps, acknowledging that the activities may include coding lessons, gaming challenges, team competitions, eSports tournaments, and technology workshops.
- [Yes/No]
- I, the undersigned parent/guardian, hereby consent to my child’s participation in the SayPro Technology and Gaming Camps, acknowledging that the activities may include coding lessons, gaming challenges, team competitions, eSports tournaments, and technology workshops.
- Consent for Media Release (Photos and Videos):
- I understand that photos or videos of camp participants may be taken during the camp and used for promotional purposes (e.g., website, social media, marketing materials).
- [Yes/No]
- I understand that photos or videos of camp participants may be taken during the camp and used for promotional purposes (e.g., website, social media, marketing materials).
- Consent for Transportation (if applicable):
- If transportation is provided by the camp (e.g., for off-site events), I consent to my child’s participation in the provided transportation to and from the event locations.
- [Yes/No]
- If transportation is provided by the camp (e.g., for off-site events), I consent to my child’s participation in the provided transportation to and from the event locations.
6. Terms and Conditions Agreement:
- Camp Code of Conduct:
- I acknowledge that my child will be expected to adhere to the camp’s code of conduct, which includes behavior expectations such as respect for others, following camp rules, and promoting a positive learning environment. I understand that failure to comply may result in my child’s removal from the camp without a refund.
- [Agree/Disagree]
- I acknowledge that my child will be expected to adhere to the camp’s code of conduct, which includes behavior expectations such as respect for others, following camp rules, and promoting a positive learning environment. I understand that failure to comply may result in my child’s removal from the camp without a refund.
- Liability Waiver:
- I, the undersigned parent/guardian, agree to release and hold harmless the SayPro Technology and Gaming Camps, its staff, volunteers, sponsors, and any other associated parties from any liability or claims that may arise during my child’s participation in the camp, except for those arising from gross negligence or willful misconduct.
- [Agree/Disagree]
- I, the undersigned parent/guardian, agree to release and hold harmless the SayPro Technology and Gaming Camps, its staff, volunteers, sponsors, and any other associated parties from any liability or claims that may arise during my child’s participation in the camp, except for those arising from gross negligence or willful misconduct.
- Insurance:
- I understand that I am responsible for providing any necessary health insurance for my child during their participation in the camp.
- [Agree/Disagree]
- I understand that I am responsible for providing any necessary health insurance for my child during their participation in the camp.
7. Payment and Registration Confirmation:
- Camp Fees:
- The registration fee for the camp is [Insert Fee Amount]. I confirm that I have completed the payment or will complete it by [insert date].
- Refund Policy:
- I acknowledge that the camp has a refund policy outlined on the registration page and understand the terms under which refunds may be granted.
- [Agree/Disagree]
- I acknowledge that the camp has a refund policy outlined on the registration page and understand the terms under which refunds may be granted.
8. Parent/Guardian Signature:
By signing below, I confirm that all the information provided is accurate and complete. I give my consent for my child to participate in the SayPro Technology and Gaming Camps, and I agree to the terms and conditions listed above.
- Signature of Parent/Guardian:
- [Signature Field]
- Date:
- [Date Field]
9. Camp Organizer Use Only:
- Camp Session Registered For:
- [Session Date and Title]
- Payment Received:
- [Yes/No]
- Emergency Contact Verified:
- [Yes/No]
- Medical Information Reviewed:
- [Yes/No]
Important Notes:
- Submission Deadline: Ensure the Parental Consent and Waiver Form is submitted at least [Insert Timeframe] prior to the camp start date.
- Health and Safety: The safety and well-being of all participants are our top priority. Please inform camp organizers of any changes in your child’s health status or emergency contact details.
- Contact Information: For any questions regarding this form or the camp, please contact us at [Insert Contact Info].
Conclusion:
The SayPro Parental Consent and Waiver Form ensures that all necessary legal consents are in place for participants under the age of 18. It provides the camp with vital emergency information, confirms parental consent for participation and media usage, and ensures both parents and camp organizers are aligned on the terms of the program. This form serves to protect both the participants and the camp organizers while enhancing the camp’s operational efficiency.
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