Youth Advisory Board Waiver & Release

Memories for Kids Youth Advisory Board.

All members of the Memories for Kids Youth Advisory Board must complete the Waiver and Release Form.

Youth Advisory Board is a group of high school students from across the Omaha community who have the desire to help us create and implement amazing memories for children who have a parent with Stage IV cancer. The students will learn how a board functions by electing officers, creating agendas and running meetings using Roberts Rules of Order. They will be challenged to create and implement their own fundraiser for Memories for Kids. Our Youth Advisory Board is also responsible for a wide variety of duties including assisting with mailings and other daily activities.

Youth Advisory Board Information -

Student Name(Required)

First Last

Student Address(Required)

Street Address City State ZIP Code

Student Email(Required)

Student Phone(Required)

What high school will you be attending in the fall?(Required)

Grade 2022-2023 School Year(Required)

T-Shirt Size:(Required)

Please select one size:

Name of Parent or Guardian(Required)

First Last

Parent's Address(Required)

Street Address City State ZIP Code

Parent's Email(Required)

Parent's Phone(Required)

Participation Fee(Required)

Price:

Donation

Requirements of the Youth Advisory Board:(Required)

- New board members agree to serve a two-year term. Board members in good standing may continue for a one-year term, not to exceed four total years.
- This Board will meet the first Wednesday of every month at 7 p.m. Meetings may be held on Zoom or in person, locations to be announced.
- Members are required to attend a minimum of six (6) board meetings a year.
- Members are required to RSVP to each meeting. Any member with two (2) unexcused absences will be removed.
- Members are required to work on a fundraiser and a project.
- Members are required to buy a ticket to Youth Advisory Board Fundraising events, in addition to volunteering at the event.

I acknowledge and agree to the requirements of the Youth Advisory Board

PICTURE WAIVER AND RELEASE(Required)

It is possible that your child could have his or her image or voice appear on Memories for Kids web page or one of the various publications that are intended to reach individuals outside of the organization. It is possible that your child’s full name will appear. Both the parent/guardian and student must give their permission to have the student’s image published in one of these forms of media. If you have any questions or concerns, please contact the Youth Advisory Board Advisor. Thank you.------- GRANT OR DECLINE PERMISSION BY SELECTING ONE BOX BELOW

- I GRANT PERMISSION to have my child’s image or voice appear in the manner described above.

- I DO NOT OFFER PERMISSION to have my child’s image or voice appear in the manner described above. I understand, however, that if my child willingly poses for a group picture that such photo may be posted in one of the forms of media described above.

WAIVER AND RELEASE(Required)

THE UNDERSIGNED DOES HEREBY IN ADVANCE WAIVE, RELEASE, ACQUIT, FOREVER DISCHARGE, AND COVENANT NOT SUE MEMORIES FOR KIDS, ITS DIRECTORS, OFFICERS, AGENTS, EMPLOYEES, AND ALL PERSONS AND ENTITIES, FROM ANY AND ALL ACTIONS, CAUSES OF ACTION, CLAIMS, DEMANDS, DAMAGES, COSTS, LOSS OF SERVICES, EXPENSES, AND COMPENSATION, ON ACCOUNT OF OR IN ANY WAY GROWING OUT OF, ANY AND ALL KNOWN OR UNKNOWN PERSONAL INJURIES, PERSONAL PROPERTY DAMAGE, OR DEATH RESULTING FROM CHILD’S PARTICIPATION IN THE ORGANIZATION. SHOULD THE UNDERIGNED OR ANY SUCCESSORS ASSERT ANY CLAIM IN CONTRAVENTION TO THIS AGREEMENT, THE UNDERIGNED AND ANY SUCCESSORS SHALL BE LIABLE FOR THE EXPENSES INCLUDING LEGAL FEES INCURRED BY THE OTHER PARTY OR PARTIES IN DEFENDING UNLESS THE PARTY OR PARTIES ARE ADJUDICATED FINALLY LIABLE ON SUCH CLAIM FOR WILLFUL AND WANTON NEGLIGENCE. THIS AGREEMENT CONTAINS THE ENTIRE AGREEMENT BETWEEN THE PARTIES, AND THE TERMS OF THIS RELEASE ARE CONTRACTUAL AND NOT A MERE RECITAL. THIS RELEASE EXTENDS TO AND INCLUDES, BUT IS NOT LIMITED TO, ALL DAMAGES OF EVERY KIND, COMPENSATORY, STATUTORY, CONTRACTUAL, AND UNDER WARRANTY, ALLEGEDLY OCCURRING BOTH IN THE PAST AND WHICH ALLEGEDLY MAY OCCUR IN THE FUTURE, WHICH COULD BE ASSERTED BY THE UNDERSIGNED, CHILD, OR BY OTHERS CLAIMING DAMAGES FROM ANY INJURIES THE UNDERSIGNED OR CHILD MAY SUSTAIN AS A RESULT OF THE EXECUTION OF THIS AGREEMENT OR CHILD’S PARTICIPATION IN THE ORGANIZATION; THESE INCLUDING ALL PREJUDGMENT AND POST-JUDGMENT INTEREST; AND ANY AND ALL OTHER ALLEGED DAMAGES, ALL LOSSES AND EXPENSES OF EVERY KIND, WHETHER KNOWN OR UNKNOWN, AND WHICH ARE OR MAY BE ATTRIBUTABLE TO THE ACTIONS OR NEGLIGENCE OF MEMORIES FOR KIDS OR ITS DIRECTORS, EMPLOYEES, OFFICERS, OR AGENTS, ALL OF WHICH ARE RELEASED HEREIN.

I am at least 19 years of age and/or the Parent/Guardian of the participant and I understand and accept the above waiver and release.

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Youth Advisory Board Waiver & Release

All members of the Memories for Kids Youth Advisory Board must complete the Waiver and Release Form.

Youth Advisory Board Information -

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