If there are child custody issues please provide details. Information is private and confidential to ensure the safety of your child.

1. While every reasonable precaution shall be taken to ensure the safety and protection of your child, the UKRAINIAN YOUTH ASSOCIATION OF CANADA (CYM) (hereinafter called “UYA”), its Directors, Officers, Staff Members, Employees, Volunteers and all facilities used by the UYA to deliver its programs, are hereby released from all and any liability, in the event of loss of personal property or any accident or misfortune that may occur to your child.

2. It is understood that should your child in any way endanger the safety and/or well-being of another individual or continually disrupt activities while attending a UYA Camp, said child will be immediately suspended from further participation in the camp program and parents will be required to take him/her home. Furthermore, fees paid will not be reimbursed.

3. In signing this form, the parent or guardian certifies that the information correctly portrays your child's medical profile and habits, and is amenable to necessary discipline if required.
4. The signature of the parent or guardian shall give the UYA and its Directors, Officers, helpers the right to arrange for any special services or other requirements necessary, in the best interest of your child and shall give the UYA the permission to obtain or approve medical interventions necessary for your child’s welfare and good health and the parent or guardian hereby agrees to pay for all such services as may be required as indicated above.
5. It is understood that in the course of UYA camp activity, pictures or recordings may be taken. I hereby authorize and release copyright to the UYA to use photographs, digital or other images in which my child appears, for UYA promotional or marketing purposes including UYA brochures, newsletters, annual reports or UYA website.
6. I hereby give permission for my son/daughter/attendee to participate in field trips planned during all UYA camps wherever they may be held. This includes outdoor adventure (hiking) camps wherever they may be organized.

I, the undersigned parent/ guardian, assume full responsibility for payment of all camp fees and medical expenses not covered by insurance I understand that I am liable for all costs related to, but not limited to damages caused by my child or children, or for additional costs incurred by the UYA as a result of my child’s or children’s actions, be they intentional or unintentional (telephone, broken windows, kiosk, etc.) The safety of each individual is of the utmost importance to the UYA. In order to ensure the safety and well-being of all participants, the UYA reserves the right to alter the program at any time without compensation to participants, parents or guardians. Furthermore, my child has been made aware of rules and regulations as found in the Handbook for parents and campers, and has agreed to abide by them.

I authorise the leaders in charge of the camp activities / excursions / events, for me and all those listed above to receive such medical or surgical treatment as may be deemed necessary, if we are incapacitated to give our consent and where it is impracticable to communicate with our Emergency Contact. I declare the information provided on this form is complete and correct. I understand that it is our responsibility to notify the Camp Administration of any changes to these details.

Camp Payments:
I agree to pay all fees and charges for this camp by the due date, or as otherwise agreed to in writing by the Camp Organising Committee.

The information collected is for the purpose of planning and organising activities for camp participants. It will be disclosed as appropriate to those conducting activities. This information will be kept securely and disposed of after the event. It is your responsibility to notify Camp Administration of any changes in details.

I give permission for photographs/videos/ images of the person / persons named previously, to be used without acknowledgement, remuneration or compensation, in various promotional materials authorised by the Ukrainian Youth Association, including but not limited to, programs, newsletters, posters, websites, social media, magazines, and newspaper articles.

Please Fill in Your name and Date. This will be taken as a virtual signature to the overall completion of declaration of this form as a legal document.

All parties over the age of 18 must fill out this section.

Please retype your email to receive confirmation that you have completed the ONLINE REGISTRATION. TO COMPLETE REGISTRATION: #1 PLEASE PRINT OFF YOUR CONFIRMATION OF REGISTRATION email. The email must include your name and the DATE of the email confirmation. The date printed must match our records. #2 ATTACH THE PRINTED EMAIL WITH YOUR PAYMENT