HBCU Parent / Adult Registration Form

Parent First Name

Parent Middle Name

Parent Last Name

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Apartment

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DOB

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Parent Email

CANCELLATION & REFUND POLICY FORM

Cancellation and Refund Policy: Due to changes in contracting with airlines, charters, and hotels, Kids 1st Foundation will not provide refunds for ANY REASON for the Tour unless the Tour is canceled prior to departure. However, you have the option to transfer deposit(s) to a new registering participate or receive a credit for a future tour. By registering I acknowledge that I have read and agree with the cancellation and refund policy for the Kids 1st Foundation HBCU Making Moves Tour.

Parent/Adult Signature

Date

TOUR RELEASE AND ASSUMPTION

Please Read Before you sign

I do hereby give my permission to participate in the HBCU Making Moves Tour presented by Kids 1st Foundation. I understand that all precautions will be taken to ensure his/her safety.

I am aware that certain dangers may occur, including but not limited to the hazards of accidents or illness in places without medical facilities, hazards created by the forces of nature, and hazards of traveling by air, bus, automobile, and other means including walking.

In the event of illness or injury, I do hereby consent to whatever x-ray examination, anesthetic, medical, surgical, dental diagnosis or treatment and hospital care considered in the best judgment of the attending physician, surgeon or dentist and performed by or under the supervision of a member of the medical staff of the hospital or the facility furnishing medical or dental services.

Kids 1st Foundation acts only in the capacity of an organizer. Its volunteers, are not agents of the suppliers of travel services and accommodations, and are not liable for any claims, suits, actions, delays, inconveniences, injuries, or any other expenses of any kind or any nature, caused by any other company providing travel services or accommodations.

I understand and do hereby assume all of the above mention risks and will hold Kids 1st Foundation and its representatives, harmless from any and all liability whatsoever, which may arise out of or in connection with the participation in activities arranged by this organization. The terms thereof shall serve as a release from assumption of risk for their Directors, Administrators, Volunteers and Chaperones.

Parent/Adult:

Parent Name:

Signature:

Date

Email:

EMERGENCY TELEPHONE CONTACT:

Name

Relationship:

Phone: (H)

Phone: (W)

Cell:

Name of additional contact: