Sleepover Guest Information and Consent Form – 2025 February Sleepover 2025: Guest information and Consent Form Parent Name(Required) First Last Parent Email Address(Required) Parent Phone Number(Required)Is another parent joining?(Required) Yes No Parent 2 Name First Last Youth 1 Name(Required) First Last Youth 1 Age(Required)89101112Youth 2 Name First Last Youth 2 Age89101112Youth 3 Name First Last Youth 3 Age89101112Youth 4 Name First Last Youth 4 Age89101112Will the named parent be in attendance with the youth participant(s)? Y or N(Required) Yes No If no, please enter the name of the Adult Chaperone here: First Last *Note that there needs to be one adult chaperone (age 21+) for every four childrenEmergency Contact Name(Required)Emergency Contact Phone Number(Required)Please indicate any dietary restrictions or allergies for any persons in this party. If there aren’t any, please enter “none”(Required)Please use this space to provide any additional information such as disability requirements or accommodation requests.How did you hear about the sleepover?Please read the following and indicate consent for all persons listed on this form:I understand that Host staff and volunteers shall lead all activities and that I/the minor agree to comply fully with their instructions. I am aware that the parent, legal guardian or chaperone of the minor is required to stay with the minor at all times during the event.(Required) I agree to the privacy policy.I understand that photographs or videos of the minor and I may be taken by the Host during the Program. I hereby grant the Host a perpetual, royalty-free license to use my/the minor’s image(s), name(s), likeness(es), and voice for any purpose deemed appropriate by the Host, including, but not limited to, exhibits, research, publications, educational, archival, and public relations purposes, as well as informational programming and notices regarding the Program on the Host’s website and social media.(Required) I agree to the policy.I understand that I will be responsible for any injury or damage I/the minor cause to the Host, including damage to personal property. I understand and expressly assume the risk of any and all damage or injury, including death, that may occur to me/the minor, or me/the minor’s property.(Required) I agree to the policy.I understand and acknowledge the minor’s participation in the Program and I hereby waive, on behalf of myself/the minor, and our heirs, any and all claims or potential claims against the Host and the Host’s employees, officers, directors, volunteers, or principals.(Required) I agree to the policy.Signature(Required)Date MM slash DD slash YYYY