Swimming with Mermaid Jai

Cancellation Policy

SOCO Clubhouse Youth Activity Permission Slip Empowering Youth Through Safe and Fun Experiences Youth Name: ___________________________________ Age: _______      Date of Birth: ___________________ Parent/Guardian Name: ___________________________________ Phone Number: ___________________________________ Alternate Emergency Contact: ______________________________ Phone Number: ___________________________________ Activities Covered: ☑ Swimming  ☑ Hiking  ☑ Kayaking  ☑ Cooking ☑ Group Outings  ☑ Sports & Recreation  ☑ Arts & Crafts ☑ Other Fun Activities (Supervised & Program-Approved) Does your child have any food allergies or dietary restrictions? ☐ No  ☐ Yes (Please list below): Other Medical Conditions or Special Needs: Permission & Release: I give permission for my child, named above, to participate in SOCO Clubhouse programs and activities, including off-site outings such as swimming, hiking, and kayaking. I understand that these activities may involve transportation and outdoor elements. I release SOCO Clubhouse, its staff, volunteers, and affiliates from any liability in the event of an accident or injury, provided reasonable safety precautions are taken. I authorize emergency medical treatment if I cannot be reached in a timely manner. Signature of Parent/Guardian: ________________________________ Date: ___________________

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