Permission & Release Form
Friday, September 11, 2026 • 6:30 PM
13868 Locust St., Trona, CA 93562
I give my child permission to attend the Teen Youth Group Swim Night at the private residence listed above and to participate in swimming and other activities taking place during the event.
I understand that my child will be swimming in a private residential pool and that swimming, pool activities, and other recreational activities involve inherent risks, including the risk of slips, falls, drowning, or other injury. I understand that reasonable supervision and safety precautions will be provided, but that these risks cannot be completely eliminated.
By signing below, I acknowledge these risks and give my permission for my child to participate voluntarily. To the extent permitted by law, I agree to release and hold harmless the homeowner, adult youth leaders, and volunteers from claims arising from my child’s participation, except to the extent caused by their gross negligence or willful misconduct.
In the event of an emergency, I authorize the adult leaders/supervisors present to obtain appropriate medical care for my child if I cannot be reached. I understand that I am responsible for any medical expenses incurred.
