Apply for FLY

Personal Information

Emergency Contact

Experience

Have You participated in the FLY Program in the past?

Are you interested in working 62.5 hours to receive 3 high school credits?

Waiver

Parent Agreement

I hereby release the program, its employees, instructors, agents and volunteers from any claim for loss, injury or damage to person or property either directly or indirectly from the attendance, including participation in any activity scheduled or unscheduled, including travel to and from any location for myself or my child.

Photography Release and Waiver

I hereby authorize the program to use photographs taken of the aforementioned indiciduals while attending or participating in the programs and activities (scheduled or unscheduled) sanctioned by the Programs Supervisor. Photographs may be used to promote the program or used in or as part of publications, advertisements, newsletters and displays intended for the general public. No other use of these photographs will be allowed.

Media Release and Waiver

I herevy authorize the program to use my child's image to be photographed or videotaped for use by TV, print or electronic media outlets (i.e. Edmonton Journal, Free Press, CBC, CTV, etc.) which may visit the program for the purpose of filming a news story, documentary or other production approved by the Program Coordinator. I understand that my child my be called upon by a journalists to answer questions which I recognize will be screened and monitored by the Program.

Field Trip and Outside Activity Permission Release

I hereby authorize my child to accompany the program on supervised activities and field trips. I understand that I will be notified of field trips in advance and will be required to sign specific field trip permission forms at that time. These trips may be within the town or surrounding area. I understand that it is my responsibilty to ensure that my child arrives at the program location by that stated time of departure. If my child misses the departure time, or I choose to have my child miss a particular trip, it will be my responsibility to arrange alternate car for these hours. Any costs involved in the participation of the field trip will be the responsibility of the family. No refunds will be granted after the deadline date.

Health Care Authorization

In case of illness or accident of my child and I cannot be reached by phone, I hereby authorize the program of their representativem to send for or seek medical assistance. I agree that the Summer Programs staff, in an emergency, may call an ambulance. All costs incurred are the responsibility of the parent or guardian.

Consent to Administer First Aid

In case of illness or accident of my child and I cannot be reached by phone, I hereby authorize program staff or their representative, who have been trained and certified in first aid, to administer any necessary first aid treatment. I agree that the Summer Programs staff, in an emergency, may call an ambulance. All costs incurred are the responsibility of the parent or guardian.

Freedom of Information and Protection of Privacy Act

Section 37 (b) and 38 (1)(c) of the Freedom of Information and Protection of Privacy Act requires that for a public body to use or disclose personal information, the individual the information is about has identified the information and consented, in the prescrived manner, to the use of the information.

By submitting this registration, I acknowledge having read and understood this liability release and accept the terms therein.

Please Note: Your child is not registered until you receive a receipt from the Town of Gibbons.

This may take up to three business days.