Upper Canada Village
CHILD INFORMATION Please make a separate copy for each additional child.
PERSON(S) AUTHORIZED TO PICK UP MY CHILD
WAIVER OF LIABILITY:
In permitting my child to attend the 2022 Youth Program operated by Upper Canada Village, I wish for my child to participate in all program activities unless I have provided written notice otherwise. My child will follow all Covid-19 guidelines as required during the time of the program. I will not send my child to the program if they are displaying any symptoms of Covid-19. I authorize the Program Director, or his/her designate, in the event of accident or illness affecting my child, to authorize all procedures and related expenses, including admission to hospital and treatment as deemed necessary for the well being of my child. Such action is to be taken only when immediate contact with the undersigned cannot be made. I agree that, having taken such precautions as in your discretion are deemed advisable, Upper Canada Village will not be held responsible for any accident or illness to my child. I also understand and agree that any pictures taken may be used for promotion of Upper Canada Village. I waive any right to compensation and/or the right to inspect or approve the finished printed material.
As a legal guardian, I authorize the above named person(s) to pick my child up from the Program. I also declare that I have read and understood, and consent the Waiver of Liability above.
For more information e-mail to: UCVyouthprograms@parks.on.ca