Important Info for the National Youth Venture Summit（四）.docVIP

Important Attendance Forms Please keep this document (5s) for your records and submit a signed copy to Youth Venture as soon as possible, via fax (703-527-8383) or email (kfurio@). You should receive confirmation that these forms have been received – if not, please contact Youth Venture. Parent/Guardian Liability Release Agreement (To be signed by parents/guardians of all youth under the legal age of 18 years old) I understand that parents and, in some instances, chaperones selected by parents in their sole discretion, shall accompany participants to the National Youth Venture Summit (“Summit”) held at Boston University, Massachusetts Institute of Technology, and Harvard College from Friday, June 26, 2009 to Monday, June 29, 2009. I acknowledge and agree that Youth Venture does not screen the parents and chaperones and disclaims any responsibility for the behavior of parents and chaperones. I realize that my son/daughter will come in contact with other participants and adults during the Summit and that there are some risks attendant to such contact. I, on behalf of my son/daughter, and myself hereby release and discharge Ashoka’s Youth Venture and the aforementioned institutions from any and all claims and liabilities arising out of, or in connection with, the Summit, including without limitation, any claims relating to contacts with other participants and/or adults. I/the chaperone selected by me shall be solely responsible for my son/daughter during the Summit. __________________________ ____________ Signature of Parent/ Legal Guardian Date Parent/Guardian Chaperone Authorization Agreement (To be signed by the parent/guardian who is agreeing to entrust their child to a Chaperone other than them self) I, _______________________________, have voluntarily chosen to entrust the sole responsibility for my son/daughter, ___________________________, to _______________________________, who will act as his/h