Global Youth Leaders Canada (GYL): Member Application Form (2020-2021) Student Information Name Name of School | Grade Contact Parent Information Name Relationship with Student MotherFatherGrand motherGrand fatherBrotherSisterLegal GuardianOther Contact Volunteering (Mandatory) Senior Home: 3-times/year Homework Club: 3-times/year General Meeting: 3-times/year Volunteering (Optional) EnsembleSamulnoriPublic Speaking Workshop Ensemble: Practice every other week (Additional fee applies) Years of Experienceless than 1 year1 year2 years3 years4 years5 years6 years7 years8 years9 years10+ years Samulnori: Practice every other week (Additional fee applies) Public Speaking Workshop: 4 sessions + Courthouse visit (Additional fee applies) Uniform (Hoodie & T shirts) Size SMLXL *2020-2021 GYL Annual membership fee $100. Public Speaking Workshop fee $80. *Payment: E TRANSFER to email@example.com *The club leaders will contact you about the fees for Ensemble and Samulnori. __________________________________________________________________________________________________________________________________________________________________ ADULT WAIVER FOR MINOR PARTICIPANT RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT, YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY! In consideration for allowing my minor child/ward to participate in the related events and activities of GLOBAL YOUTH LEADERS CANADA, I hereby warrant and agree: 1. I am the parent/guardian having full legal responsibility for decisions regarding my minor child/ward; 2. I am familiar with and accept, on behalf of myself and my minor child/ward that there is the risk of serious injury and death in participation in GLOBAL YOUTH LEADERS CANADA activities; 3. I have satisfied myself and believe that my minor child/ward is physically, emotionally and mentally able to participate in GLOBAL YOUTH LEADERS CANADA activities; 4. I understand, and will instruct my minor child/ward, that all applicable rules for participation must be followed and that, at all times, the sole responsibility for personal safety remains with my minor child/ward; 5. I will immediately remove my minor child/ward from participation, and notify a GLOBAL YOUTH LEADERS CANADA mentor, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that my minor child/ward has experienced any deterioration in his/her physical, emotional or mental fitness for continued participation in GLOBAL YOUTH LEADERS CANADA activities; and 6. I authorize GLOBAL YOUTH LEADERS CANADA to consent to emergency medical treatment in accordance with the best interests of my minor child/ward, should I not be present at the relevant time to grant consent myself. I UNDERSTAND AND AGREE, ON BEHALF OF MY MINOR CHILD/WARD, HIS/HER HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND NEXT OF KIN, MYSELF, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND NEXT OF KIN THAT MY EXECUTION OF THIS DOCUMENT CONSTITUTES: 1. AN UNQUALIFIED ASSUMPTION OF ALL RISKS associated with participation in this event by my minor child/ward even if arising from negligence or gross negligence, including any compounding or aggravation of injuries caused by negligent first aid operations or procedures, of the applicable organizer of the activities, the activity venue and any persons associated therewith or participating therein; 2. A FULL AND FINAL RELEASE AND WAIVER OF LIABILITY AND ALL CLAIMS that I have or may in the future have against GLOBAL YOUTH LEADERS CANADA and its directors, officers, mentors, employees, representatives, advertisers, other participants, sponsors, (all of whom are collectively referred to as “the Releasees”) from any and all liability for any loss, damage, injury or expense that my minor child/ward may suffer, or that his/her next of kin may suffer as a result of his/her participation in or presence at GLOBAL YOUTH LEADERS CANADA activities due to any cause whatsoever, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE RELEVANT OCCUPIERS LIABILITY ACT OR ANY OTHER RELEVANT STATUTES, on the part of the Releasees; 3. AN AGREEMENT NOT TO SUE THE RELEASEES for any loss, injury, costs or damages of any form or type, howsoever caused or arising, and whether directly or indirectly from the participation of my minor child/ward in GLOBAL YOUTH LEADERS CANADA activities; 4. AN AGREEMENT TO INDEMNIFY, and to SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them whether the claim is based on the negligence or the gross negligence of the Releasees or otherwise; and 5. AN ACKNOWLEDGMENT that I HAVE READ THIS DOCUMENT THOROUGHLY. I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT, BY SIGNING THIS AGREEMENT, I AM WAIVING CERTAIN SUBSTANTIAL LEGAL RIGHTS WHICH MY MINOR CHILD/WARD, HIS/HER HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS AND I MAY HAVE AGAINST THE RELEASEES.