Permission/Waiver for the 2024-25 YouthWorks 30-Week After School Program, School Break Camps, Church Services, Youth Group, Summer Camp or Any Other Initiative Facilitated by the Organizations Below.

I give permission for all of the children/youth to participate in all activities of the YouthWorks After School Program, Summer Camp, School Break Camps, church services, youth group, or any other initiatives facilitated by and/or sponsored by the Tulsa Cornerstone Assistance Network, Wesley Chapel, and all other organizations partnering with and/or serving with these activities in any way.  I understand that my child(ren)/youth will be supervised by staff and/or volunteers from Wesley Chapel (hereafter knows as Wesley), Tulsa Cornerstone Assistance Network (hereafter known as Cornerstone), YouthWorks, YouthWorks Pizza Factory, YouthWorks Ranch and/or any or all of our partner entities and any place or organization that participates in, leads and/or sponsors on-site activities, off-site activities, and including transportation to and from any site, home, school or any field trips by authorized & approved person(s).

I, being the parent and/or legal guardian of the aforementioned children/youth(s), do hereby give permission for the child(ren)/youths listed above to participate in all field trips and activities provided by Wesley, the Opportunity Project, YouthWorks, YouthWorks Pizza Factory, YouthWorks Ranch, Cornerstone and any and all partner entities or persons.  My participating child(ren)/youths and I hereby release, forever discharge and agree not to hold accountable Wesley, Cornerstone, YouthWorks Pizza Factory, YouthWorks Ranch, and its agents, affiliates, partners, staff and volunteers in the case of personal injury, sickness, property damage, or death while said child(ren)/youth are active in the After School Program, Summer Camp, School Break Camps, Church Service, Youth Group, or any other initiatives facilitated by the organizations in this waiver.    

I/we give permission for our child(ren)/youths to participate in the activities located on the Wesley property, YouthWorks Ranch, and/or any other location.  I/We understand that health, safety, and behavioral issues are important for all concerned and that my child/youth must follow all instructions given for his/her best interest.  I/We also understand that the camp leadership and any or all partners will not be held responsible for any criminal acts, violence against another person or property, inappropriate language, or any other behavior deemed inappropriate and are not in compliance with the program guidelines or leadership requests.  I/we are aware that I/we will be notified of problems that occur & will be asked to pick up my children/youth.

I authorize my child(ren)/youth to receive first aid or any other emergency medical treatment should my child(ren)/youth become ill or injured while in the care and supervision of these organizations, their leaders, directors, and/or managers.  I also authorize the responsible leadership of the above-mentioned organizations to give necessary “parental/guardian consent” on my behalf for a licensed physician, surgeon or dentist to administer any medical, surgical, or dental treatment deemed necessary to aid the child(ren)/youth listed below.  Every reasonable effort will be made to contact me immediately upon discovery of the emergency.  I further understand that I will be held responsible for any and all expenses that might accumulate.   This consent is given in advance of any specific diagnosis or treatment being required, and is given primarily to encourage those who have temporary custody of my child(ren)/youth, and the said physician, surgeon, medical personnel, or dentist to exercise their best judgment in situations deemed an emergency as to the requirement of such diagnosis or medical, surgical or dental treatment.

I also hereby give permission for Cornerstone, YouthWorks, Wesley, YouthWorks Ranch, YouthWorks Pizza Factory, any partners, any sponsors, any corporations or foundations or non-profits or any other entities to use photos, video and any likeness of my child(ren)/youth or other information, in presentation designed for publicity purposes for these organizations and/or sponsorships to raise funds for all of the children/youth programming activities so they can participate, and understand that I will not receive any monetary or other reward, and pictures taken or used and videos taken or used belong to these organizations.  I also give permission for my child(ren) and their information to be used to raise sponsorships for them and other children to cover the expenses of serving them in all activities.  I also agree that any data collected about my child(ren)/youth may be shared with our partners or any other entity.  My signature below indicates I have read and understand all Permission & Liability Release I am giving, the Authorization for Emergency Medical Care, photo/video/likeness usage, and terms for participation in this program, and agree with all info herein.

By typing my name below I agree to the above statement: