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Convention - Youth Form

EARLY Youth Registration - Colorado Convention 2021

Release

Release statement required for all DeMolay participating in Colorado Convention 2021. This form must be signed by a parent.

I grant permission to the jurisdiction of Colorado and it's subordinates, including all Chapter(s) and related organizations to use my photo for use in DeMolay publications such as recruiting brochures, newsletters, and magazines, and to use my name and/or photographs on display boards, any photographs in electronic versions of the same publications or on the Colorado DeMolay website or other forms of social media. 

In the event of an emergency involving the participant listed under the Colorado DeMolay State Convention registration, I understand every effort will be made to contact the emergency contact listed. In the event that he/she cannot be reached, the participant and/or the parent/legal guardian hereby give permission to the medical provider selected by the adult leader in charge for treatment, including hospitalization, anesthesia, surgery, or injections of medication for the participant. Medical providers are authorized to disclose their examination findings, test results, and treatment provided for the purposes of medical evaluation of the participant, follow-up and communication with the parent or guardian, and/or determination of the participant's ability to continue in the programmed activities. 

Emergency Information

Youth will not be allowed to participate without a permission slip signed by your Parent/Guardian on file. I give permission for my child to join the DeMolay of Colorado, in the activities sponsored by the State Organization, its staff, and sponsors. I hereby release them from responsibility from any/all illness or injury that my child may sustain during this activity/event. In the event of an emergency, I hereby authorize an adult leaderof this activity as agent for me, to consent to an x-ray examination, medical, dental or surgical diagnosis, treatment and hospital care advised and supervised by a physician, surgeon, dentist (as appropriate), licensed to practice under the laws of the state where the services are rendered, either at a doctor's office, urgent care facility, or in any hospital. I will expect to be contacted as soon as possible.

Agreement to Guidelines and Waivers

Youth will not be allowed to participate without a permission slip signed by your Parent/Guardian on file.