Junior Youth Group Registration Form

My child, indicated on this form, has my permission to participate in Congregation Kol Ami’s Junior Youth Group. In consideration of my child’s acceptance as a youth group paricipant, I hereby waive any and all claims against Congregation Kol Ami, its agents, employees and volunteers, that may arise out of injury, loss or damage suffered by my child during any youth group or temple activity.

I also consent for my child to be transported to and from any youth group program by school bus, coach bus, Congregation Kol Ami staff member, youth group staff and volunteers and/or by other parents or youth participants in case of carpooling.

On behalf of myself, my heirs and assigns, my personal representatives, administrators and executors, and my child (if under the age of eighteen years), I do hereby release, discharge, indemnify and hold harmless Congregation Kol Ami (CKA), any and all faculty members and youth group staff members, their agents, representatives, employees and volunteers, from and against any and all claims, demands, causes of action, liabilities, damages, and personal injuries, including death, property damage, economic losses, or loss of any nature or cause including costs and attorney fees in connection with or arising from participation in any meeting, activity, or trip.