2024 Beacons Community Field Trip Consent Form
Dear Participant, Conservator or other designated representative:

Completion of this form is required for all individuals wishing to participate in off-site activities hosted or supervised by Beacons, Inc. Please COMPLETE, SIGN and RETURN this form to the person in charge of your division or activity (e.g. program director or instructor).

DURATION OF CONSENT
This consent will remain in effect for the duration of the year in which it was completed. (For example if completed on a date in 2023, it will be in effect for the entire year of 2023, unless revoked in writing).

LOCATIONS
Community visit are typically to various business and other community locations within an approximately 15 - 20 minute driving radius of Beacons, Inc. There may be occasions where participants will walk to nearby community locations with instructors.

Private vehicles of Beacons staff and/or volunteers may be used.

1. FOR PARENTS (or LEGAL GUARDIANS or CONSERVATORS)
(If you are NOT a parent or legal guardian or conservator, please go to section #2 "Individuals" below.

If you are completing this on behalf of a loved one who IS NOT conserved, that person should be the person completing this form. You can help them if they need help, but for this to be binding, it needs to be completed by them. They will be given the option to give us consent to speak to you about things at Beacons the involve them.

If your child/adult child IS conserved, please complete this form as their conservator IF your Letter of Conservatorship give you authority to enter into contracts on behalf of someone who is conserved. 

2. FOR INDIVIDUALS WHO ARE NOT CONSERVED
If you are not "conserved," you should complete this form to give your consent to go on community field trips. We recommend that you complete this with a parent or other trusted contact. 

3. WHAT DOES "CONSERVED" MEAN?
If people have a lot of troubles making decisions, a family member or someone may get court approval to make the decisions for the person. If the Court agrees that you cannot make decisions on your own, the court will approve a "Letter of Conservatorship" that lets someone else help you by making certain types of decisions for you. If you are not sure if you are conserved or not, ask your parent or the person who you live with if they know if you are "conserved" before completing this form. If you ARE conserved, you will need someone else to complete the form with your input.

If you have any questions, please do not hesitate to contact as follows:

FOR CLUB BEACONS: Club@BeaconsNorthCounty.com
FOR EXPLORER: Explorer@BeaconsNorthCounty.com
FOR PATHFINDER: Pathfinder@BeaconsNorthCounty.com
FOR STUDIO BEACONS: Studio@BeaconsNorthCounty.com
FOR TAILORED DAY: TailoredDay@BeaconsNorthCounty.com

Thank you!
The Beacons Team

2245 Camino Vida Roble, Suite100 

Carlsbad, CA 92011

Office Number: 760-448-6230


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Email *
Participant's First and Last Name *
Participant's Cell Phone: *
Birthdate:
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DD
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YYYY
Person completing this form: *
Relationship of person completing this form to the participant: *
Required
EMERGENCY CONTACT #1 INFORMATION: Please provide the name, cell number and email of first emergency contact. *
EMERGENCY CONTACT #2 INFORMATION: Please provide the name, cell number and email of second emergency contact.
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CONSENT TO PARTICIPATE IN COMMUNITY-BASED ACTIVITIES: The participant consents or has permission to attend and participate in offsite activities by Beacons, Inc.  
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ABILITY OF PARTICIPANT TO PARTICIPATE: The participant is healthy and capable of participating in said off-site activity/ies without causing a risk of danger, illness or accident to themselves, or to others. 
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CONCERNS ABOUT COMMUNITY ACTIVITIES: If there are any concerns about the participant participating in off-site activities, or if there is a potential risk of danger, illness or accident to themselves or others, please describe below: *
Is participant CONSERVED? (If you do not know, please ask your parent or SDRC service coordinator). *
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