High-Risk Activity Permission Form
Match ID
Match Owner Email
NOTE:
*THIS FORM IS ONLY VALID IN THE YEAR IT IS SUBMITTED*
You will need to submit a new High-Risk Activity Form to continue this activity in the new year.
Who Is Completing This Form
I am a:
Parent/Guardian
Big
Your Agreement
Your First Name
Your Last Name
Personal Email
Your Child's First Name
Your Child's Last Name
What is the activity?
I realize that Big Brothers Big Sisters of the Midlands (BBBSM) views this as a high-risk activity and that BBBSM is not liable for anything that occurs during this activity. I also understand that this activity is out of the scope of BBBSM’s program. I assume all responsibility through giving my permission for my child and their Big(s) to participate in the activity. It is also understood that BBBSM is not financially liable, under any circumstances, should an accident occur.
I acknowledge and will adhere to the information that BBBSM has presented above.
Your Agreement
Your First Name
Your Last Name
Personal Email
Your Little's First Name
What is the activity?
I realize that Big Brothers Big Sisters of the Midlands (BBBSM) views this as a high-risk activity and that BBBSM is not liable for anything that occurs during this activity. I also understand that this activity is out of the scope of BBBSM’s program. I assume all responsibility through giving my permission for my child and their Big(s) to participate in the activity. It is also understood that BBBSM is not financially liable, under any circumstances, should an accident occur.
I acknowledge and will adhere to the information that BBBSM has presented above.
Your E-Signature
After submitting this document, you will be redirected to another page where you will complete an e-signature. Then, an email will be sent to your personal email address with a link t
o verify it
.
Contact Information