WAIVER FORM

CAPITAL YOUTH OUTREACH CLUB (CYOC)

PARTICIPANT WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND MEDIA CONSENT

Form Version: 2026.01

Capital Youth Outreach Club (CYOC) is a nonprofit organization dedicated to youth leadership, education, volunteer service, and community engagement.

Please read this document carefully before signing.

1. Voluntary Participation

I voluntarily choose to participate in activities organized, sponsored, or supervised by Capital Youth Outreach Club (“CYOC”). I understand that my participation (or the participation of my minor child) is completely voluntary.

2. Acknowledgment and Assumption of Risk

I understand that CYOC activities encompass a wide range of programs and inherent hazards.

  • Activities include, but are not limited to:
    • Community service, volunteer work, festivals, and public events
    • Summer camps, leadership training, educational classes, and workshops
    • STEM workshops, science experiments, robotics programs, and rocket launches
    • Astronomy observation and outdoor recreation (including hiking)
    • Sports (pickleball, basketball, badminton, etc.)
    • Performances, competitions, and event-related travel
  • Inherent risks include, but are not limited to:
    • Falls, slips, and physical contact with other participants
    • Muscle strains, fractures, or serious bodily injury
    • Weather-related hazards, fire, burns, or insect bites/allergic reactions
    • Equipment malfunction or property damage
    • Vehicle accidents during transit
    • Illness, communicable diseases, permanent disability, or death

I voluntarily assume all known and unknown risks associated with participation in CYOC activities.

3. Release of Liability

To the fullest extent permitted by applicable law, I release, waive, discharge, and hold harmless Capital Youth Outreach Club (CYOC), its officers, directors, board members, advisors, volunteers, instructors, coaches, event organizers, sponsors, partner organizations, property owners, and agents from any and all claims, liabilities, damages, losses, costs, attorney’s fees, or causes of action arising out of participation in CYOC activities.

  • This release applies to claims arising from ordinary negligence.
  • This Agreement does not release claims resulting from gross negligence, reckless conduct, willful misconduct, or intentional wrongdoing to the extent prohibited by Maryland law.

4. Medical Authorization & Responsibility

  • I certify that I (or my child) am physically and mentally able to participate safely.
  • In the event of a medical emergency, I authorize CYOC representatives to obtain emergency medical treatment if I or my designated emergency contact cannot be reached.
  • Insurance & Expenses: I understand that CYOC does not provide medical insurance. I am responsible for maintaining primary health insurance and accept full financial responsibility for all medical expenses incurred.

5. Participant Responsibilities

I agree to:

  • Follow all safety rules, policies, and instructions from organizers, instructors, and volunteers.
  • Wear appropriate safety gear and equipment when required.
  • Treat all participants, staff, volunteers, and property with respect.
  • Refrain from unsafe, illegal, or disruptive behavior.
  • Disclose any medical conditions or allergies that could impact safe participation.

CYOC reserves the right to remove any participant whose behavior creates a safety risk or disruption, without refund (if applicable).

6. Transportation

If transportation is provided by volunteers, parents, or other participants, I acknowledge that CYOC is not a commercial transportation provider and voluntarily accept all risks associated with travel to and from activities.

7. Personal Property

I understand that CYOC is not responsible for the loss, theft, damage, or destruction of personal belongings.

8. Photography and Media Release

I grant permission to CYOC to photograph, video record, or capture my (or my child’s) image, voice, or likeness during activities. I authorize CYOC to publish or distribute these materials without financial compensation for:

  • Websites, social media, and promotional materials
  • Newsletters, annual reports, and grant applications
  • Educational and club materials

9. Communicable Diseases

I acknowledge that participation in group or public activities carries inherent risks of exposure to communicable diseases (including COVID-19, influenza, and other infectious illnesses). I voluntarily assume these risks.

10. Governing Law & Severability

This Agreement shall be governed by and construed in accordance with the laws of the State of Maryland. If any provision of this document is found to be unenforceable, the remaining provisions shall remain in full force and effect.

11. Final Acknowledgment & Authorization

By signing below, I acknowledge that:

  • I have carefully read and fully understand this Agreement.
  • I understand that I am giving up substantial legal rights on behalf of myself and/or my child.
  • I sign this Agreement freely, knowingly, and voluntarily.

SIGNATURE BLOCK

Participant Information

  • Participant Full Name: __________________________________________________
  • Date of Birth: ______________________ Phone: ________________________
  • Emergency Contact Name: ____________________ Phone: ____________________

Adult Participant Signature (If participant is 18 years of age or older)

  • Signature: ________________________________________ Date: _______________

Parent / Legal Guardian Consent (REQUIRED if participant is under 18 years of age)

I certify that I am the parent or legal guardian of the minor named above. I have read and fully understand this Agreement, consent to my child’s participation, and agree to all terms on their behalf to the fullest extent permitted by law.

  • Parent/Legal Guardian Name: _____________________________________________
  • Signature: ________________________________________ Date: _______________
  • Relationship to Minor: ____________________ Phone: _____________________