Two Feathers NAFS Partnership Programming Interest Form
Please sign one youth up at a time.  This form is for interest only.  You will be contacted for more details as interested activities approach. 
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Youth Information
Please input youth information below
YOUTH’S FIRST NAME *
YOUTH'S LAST NAME *
YOUTH'S AGE *
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YYYY
HOW DOES THE YOUTH DESCRIBE THEIR GENDER? *
YOUTH'S TRIBAL AFFILIATION *
Required
WHAT CITY DOES THE YOUTH RESIDE? *
WHAT SCHOOL DOES YOUTH ATTEND
Clear selection
Parent/Guardian Information
Please input Parent/Guardian Information below.
PARENT/GUARDIAN FIRST AND LAST NAME *
PARENT/GUARDIAN PHONE NUMBER *
PARENT/GUARDIAN EMAIL *
WHICH PROGRAMS ARE YOU INTERESTED IN (CLICK ALL THAT APPLY) *
Required
IS TRANSPORTATION NEEDED? TRANSPORTATION IS LIMITED AND WE WILL PRIORITIZE CURRENT TWO FEATHERS YOUTH  *
LIABILITY WAIVER
For individuals needing special accommodations to participate in the activities sponsored by Two Feathers

Native American Family Services, please notify Two Feathers at least five working days prior to the first day of at-tendance. It is recommended that all participants carry their own insurance coverage. Waiver:(all classes require the signature of each registering adult or the parent or guardian of any minor(s). In consideration for being allowed to participate in Two Feathers NAFS programs, I, the undersigned, agree to indemnify, hold harmless, and release Two Feathers, its employees, agents, independent contractors, volunteers, officials, and officers (collectively the “Two Feathers”) from negligence, excepting gross negligence, and any and all liability for any injury which may be suffered by me, my minor child(ren), or any member of my household account (hereinafter collectively the “Household Members”) arising out of, or in any way connected to participation in any Two Feathers sponsored recreational program and agree to refrain from bringing any claim, lawsuit or other proceeding against Two Feathers stemming from any such personal injury. I agree to take responsibility to ensure that all Household Members enroll in activities at the appropriate level for their physical abilities and medical conditions and fully understand that I and Household Members assume all risks for any injuries received. I expressly acknowledge that risks, known and unknown, are inherent in recreational programs. I authorize Two Feathers employees and agents to seek emergency medical care, as they deem necessary, for any Household Member participating in any Two Feathers sponsored recreational program and agree to be responsible for all costs incurred. I acknowledge that Two Feathers may take publicity photographs and/ or recordings of any Two Feathers sponsored activity or event and hereby authorize the use of any Household Member's image for this purpose. If any term, clause, or provision of this Release of Liability is held to be illegal, invalid or unenforceable, the remainder of this Release of Liability shall not be affected thereby, and shall be enforceable to the fullest extent permitted by law. I have read and understand the above agreement and fully assume all risks for any injuries received.
THIS IS AN AGREEMENT THAT AFFECTS IMPORTANT LEGAL RIGHTS. PLEASE READ THE FOREGOING AGREEMENT CAREFULLY BEFORE SIGNING. IF YOU DO NOT UNDERSTAND ANY PART OF THE AGREEMENT, PLEASE CONSULT AN ATTORNEY OR ADVISOR. DO NOT SIGN UNLESS YOU FULLY UNDERSTAND AND AGREE.
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TRANSPORTATION WAIVER
I give my consent for my child named below to be transported by
Two Feathers Native American Family Services and will assume all liability for my or their participation in this activity and any injury that may result during the provided transport or at the activity.
Furthermore:
1. I will not hold Two Feathers Native American Family Services, its employees, agents,
assigns, or anyone acting on its behalf liable for injury or death occurring to the person
named herein in the course of the activity or travel.
2. I accept financial responsibility for personal items lost by the person named herein.
3. I authorize Two Feathers Native American Family Services to obtain, through medical personnel of its own choice, any medical care that may become reasonably necessary for the person named herein in the course of such activities and travels and, additionally, agree to accept the cost of the transportation and/or medical treatment by medical personnel or facility.
4. If by law my child requires a car seat of booster seat, I am responsible for providing a car seat/booster seat and installing it in the vehicle.
5. I accept full responsibility and hereby grant permission for me and my minor child to travel with Two Feathers Native American Family Services.
I have read the Two Feathers Native American Family Services guidelines, and I understand that
limited transportation is available on a first-come, first-serve basis. I give permission for Two
Feathers Native American Family Services staff members to transport my child to and from Two Feathers Native American Family Services
sponsored events and/or activities and hereby agree to all terms of this waiver.
 *

Behavior Expectations and Agreements

I understand and accept the rules and guidelines of Two Feathers Outreach Programming and understand and accept the consequences for my child/ren if they breach the Code of Conduct. 

Listen and show respect to the coordinators, volunteers, and peers. 

Be responsible, stay with the group.

Use appropriate language: swearing, racial or sexual slurs/joke/comments will not be tolerated. 

Respect property  

Feel free to express to the coordinators any concerns or problems I have.

Treat others the way I would like to be treated.  

Think before I act or react.

Be responsible for my own belongings. 

Use your manners: please and thank you go a long way.

Will not bring or use any illegal substances such as but not limited to marijuana, alcohol, opioids, cigarettes, vape pens, etc. while at a Two Feathers NAFS program or activity or be under the influence upon arrival to program.

Behave in a manner that will reflect favorably on you and the group, as you are not only representing Two Feathers NAFS but your family and community as well.  

Safety in vehicles during transportation

 I understand that failure to comply with the Code of Conduct may result in a behavioral contract, suspension, or expulsion from any Cultural or Youth Program Two Feathers Sponsors.  

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