Acknowledgement And Consent Of Parent / Lawful Custodian

The undersigned (print name) is the parent or lawful custodian of the following minor who is participating in the ‘no-cost’ program accessible to all young Canadians (for convenience, referred to as “my child”)

Name of Participant:
Date of Birth (dd/mm/yyyy):
Address:
I have read and acknowledge each of the following statements:

1. Participation in the program by my child, including my child’s involvement in all program activities, travel to and from the program activities, any and all transfers between program activities, and certain non-program-related activities during the course of the program (such as meal times, and “free” time; the entirety of this time away may be referred to for convenience as “the field trip”), is not without inherent risks. These risks include, but are not limited to, the risk that my child may, at any time during the field trip, and for any number of reasons foreseen and unforeseen, suffer or incur physical injury, possibly severely or even fatally.

2. I have read the relevant background material and program itinerary, or have otherwise informed myself sufficiently regarding the program and the activities my child will be engaging in while away from my care during the field trip and am adequately aware of what my child will be doing.

3. I confirm that my child is a Canadian citizen, permanent resident or person who has been granted refugee status in Canada.

4. I have had the opportunity to ask questions regarding the program and activities to be conducted, which the organizers of the program were able to address to my satisfaction, and have no further questions regarding the program or field trip. I understand that should any questions arise during my child’s participation in the program or field trip, I may contact CWF directly.

5. Considering CWF is one of the organizers of the program, CWF will be responsible for the supervision of youth participants during the program and field trips, providing reasonable care and diligence in exercising this duty. All in-person programs with youth under the age of 18 will be supervised by at least one (1) CWF staff member and one (1) non-staff member supervising adult. The non-staff member will be screened by CWF prior to participating in the program and may be a volunteer, parent, professional outdoor guide or leader from another organization.

6. Although I fully expect that my child will conduct themselves properly and responsibly during their participation in the program and field trip, it is possible that while they are away from my care they may misbehave, be uncooperative, be physically/emotionally aggressive with others, or may pose additional risks in circumstances that are beyond the knowledge and control of the organizers of the program.

7. I or someone on my behalf may be summoned to the program activity by CWF or its agents to physically escort my child home, at my sole expense, if circumstances arise during the field trip which, at the sole discretion of CWF, its officers, directors, employees or agents, warrant such action.

8. I or someone on my behalf has adequately informed the organizers of the program and the field trip of any disabilities, allergies, or special requirements my child has or may have, and that in my opinion and to the best of my knowledge my child is in good physical health as of the date that I have signed this Acknowledgement and Consent form.

9. CWF is not responsible for selecting or purchasing insurance, including risk, life, health, and travel insurance for or on behalf of my child in relation to any matter or risk associated with the program or the field trip. I have been given the opportunity to acquire all such insurances, and have either done so to my satisfaction, or have conscientiously declined to do so and am assuming the risks that flow from that fact.

10. I will indemnify CWF, its officers, directors, employees or agents in respect of any loss or cost that is in any way related to my child’s participation in the program or the field trip, and that is not the result of gross or wanton negligence on the part of CWF.

11. Despite this Acknowledgement and Consent form, to the extent that my child, their representative, legal custodian, or family member, brings a legal claim or action against CWF based on allegations related to the program and/or the field trip, all such litigation shall be commenced in Ontario, and Ontario shall be the forum for all such litigation, up to its final disposition and appeal, if any.

12. This Acknowledgement and Consent form may be signed and submitted via email or facsimile transmission, and such copies shall be legally enforceable.

Additional Acknowledgements:

- WILD Outside is committed to being a barrier-free program that is accessible to all young Canadians.

-Some of the scheduled program activities require specific equipment and/or transportation to event meet-up locations. All rental costs and excursion fees are covered by the program. If additional financial assistance is required to enable their participation, subsidies are available and reviewed by staff for eligibility. Please inquire with staff for more details.

-Participants will receive a CWF certificate of completion recognizing their service and contributions.

I unreservedly consent to my child participating in the program and in the field trip.

Name of Parent/Guardian should be valid.