LogoHigh Risk Activity Permission Form






Your Information 








With my electronic signature, I hereby waive and release Big Brothers Big Sisters of Greater Chattanooga and all individuals, staff members, or volunteers working in connection therewith from any and all possible claims for injury to person or property which might arise with my child’s participation in the above activity. I do not hold Big Brothers Big Sisters of Greater Chattanooga or Big Brothers Big Sisters of America, staff, or volunteers responsible for any accident or illness which might occur and authorize the adult in charge (should it be necessary) to secure the service of a doctor at my expense. 

Emergency Contact Information 

In the event of an emergency and I am unable to be contacted, the following are sources of assistance.