Youth Member Information
Guardian 1 Information
Guardian 2 Information
Emergency Contact/Authorized Pickup List
Acknowledgement and Consent: I understand the conditions under which the Boys & Girls Club of Bowling Green (aka the Club) operates and that it is not a day care facility. I understand the sign in/sign out policy which requires the member to sign in to the program and the parent to sign the member out. Professional supervision will be proved fo children at the Club facility, and on Club field trips. I understand that no loitering is allowed outside the Club entrance. For both internal and external use, I acknowledge that the Boys & Girls Club of Bowling Green may utilize photographs or videos of my child taken during involvement in Club activities. I consent to such uses and hereby waive any rights of compensation. The Club offers educational programs with age appropriate curriculum such as SMART Moves, SMART Girls, and Passport to Manhood which discuss life skills, personal hygiene, sexual health and development, how to manage peer pressure and relationships, and the dangers of drugs and alcohol. By signing this application, you give permission for your child to participate in these programs.
Waiver of Liability &
Disclaimer: In consideration of
my child's membership and participation in the activities and special programs
or events of the Club, on behalf of me and my child, waive, release, and agree
to defend and hold harmless Boys & Girls Club of Bowling Green, including
its sponsors, staff members, board of directors and any other affiliated
persons and/or vehicle drivers from any and all claims, injuries, death,
damages, and demands arising or in any way resulting from or connected to any
Club related event, activity, program or property. I attest and verify
that I have full knowledge of the risks involved in Club-related events,
activities, programs and properties and that I will, on behalf of my child,
assume and pay any medical or emergency expenses. I further acknowledge
that my child is physically fit to participate in the programs or other
activities of the Club.
Attendance Policy: The Club reserves the right to assume a member is no longer
active if he/she does not attend the program at least three days per
week. If he/she is transported by van to Boys & Girls Club, he/she
must attend the program at least three days each week or shall be subject to
Emergency Authorization: I, the undersigned, as the parent/guardian of my child hereby
authorize the staff of the Club, its sponsors, and vehicle drivers as my agents
to consent to medical, surgical, dental examination or treatment of my
child. In case of emergency, I hereby authorize treatment or care at any
hospital or by any licensed medical personnel.
"Remind" App: The Club utilizes a text messaging app called
"Remind" to provide parents and guardians with updates and reminders
regarding Club policy, events, special hours, field trips, etc. please
list a working mobile phone number that can receive text messages.
Your signature below acknowledges that you have read and accept the policies/conditions of the Boys & girls Club of Bowling Green as described above.