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2. 
4. Tifton Youth Council Medical Treatment, Release of Liability and Photo Authorization Form

   I understand and accept the risk that injuries or accidents may occur while my Child (Child's name listed below) travels as a participant in activities of the Tifton Youth Council (TYC) for the 2023-24 school year. I hereby authorize the officials of the Tifton Youth Council to make whatever decisions necessary for my Child's welfare in the discretion of said officials while my Child travels and participates in TYC activities. In the event my Child requires medical treatment for injuries or accidents while traveling to or from activities or while participating in activities, I hereby request, authorize and consent to medical treatment as necessary for my Child. I agree to be responsible for all medical expenses incurred in connection therewith and to reimburse the City of Tifton in full in the event that the City of Tifton incurs said expenses. 

   I release and hold the City of Tifton, Georgia, Mayor and Council, the TYC Advisory Board, officers and employees of the City of Tifton, Georgia, harmless from any and all liability, damages, claims, suits, demands and judgements of whatever nature for injuries to my Child or damage to property arising out of any and all events, including, but not limited to, travelling to and from TYC activities. I assume the risk of any and all injuries occurring to my Child arising out of any and all events for the Tifton Youth Council including, but not limited to, traveling to and from Tifton, Georgia.

   The City of Tifton, and its partners and affiliates, may use all photographic images, video or audio recordings, video or audio reproductions, films, radio or television broadcasts and any other reproductions of the Tifton Youth Council activities without limitations.

   By typing Full Name below, I agree to the terms above regarding my Child's participation in the Tifton Youth Council.  

6. Child's Full Name*
8. Insurance Company*
9. Policy Number*
11. Food/Drug Allergies*
13. Any Other Known Medical Condition(s)*
15. Mailing Address*
17. City*
18. State*
19. Zip Code*
21. Emergency Contact Name*
22. Emergency Contact Phone Number*
24. Parent/Guardian Name*
25. Parent/Guardian Email Address*
26. Parent/Guardian Cell Number*
28. Parent/Guardian (Type Full Name)*
29. Date*
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31. 1. Receive an email copy of this form.
32. Email address

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33. Submit

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