Join
the Boys & Girls Clubs of Delaware County

The Boys & Girls Clubs of Delaware County, and its affiliates, are not responsible or liable in any way in the event of harm or injury occurring to the member. It is agreed that the parent or guardian will not hold Boys & Girls Clubs of Delaware County responsible for the welfare or whereabouts of the member. If the Parent or Guardian does file a complaint against the Club the Parent or Guardian agrees to pay for Boys & Girls Club of Delaware County’s legal fees.

I give the Boys & Girls Clubs of Delaware County my release to secure medical attention for my child as necessary, including transportation to medical facilities. If an emergency arises, I understand that Club personnel will try to contact me and my alternate contacts, but I release this right to them in the event of my being unreachable. I understand and approve of the procedures the Club has set for emergencies, and wish for them to take the necessary action to maintain my child’s health.

I understand that:

- If I bring my child to the Club, I will need to sign them in. If my child arrives on their own, they must sign themselves in.
- My child should be signed out by an adult in order to leave the Club. Once my child has signed out, the Club is no longer responsible for my child.
- Youth are not allowed to use the Club phone to make “visiting”, overnight, or other arrangements, as this can lead to confusion on the part of the parents as to the location of their child.
- I am taking full responsibility for any damage that my child may be responsible for - full or in part - and that I will be held financially accountable for those damages.

**Form must be completed and returned before membership is activated.

I have received the Parent & Member Handbook packet and completed a membership

enrollment form. By enrolling my child as a member of the Boys & Girls Clubs of

Delaware County, I agree to adhere to and abide by the policies of the Club as stated

in the Parent & Member Handbook. I also agree that my child, if between 7-11 years

of age, will be enrolled in our TRAIL Diabetes Prevention Program, asked to

participate in the annual National Youth Outcomes Initiatives survey and take part in

the Smart Moves program. Ask your unit director for more details regarding TRAIL,

NYOI and Smart Moves. A copy of the Boys & Girls Clubs of Delaware County’s Safety

Policies is available upon request.