By Submitting this form I give permission for the above named individuals to participate in the Wilton-Lyndeborough Youth Center (WLYC) programs. I certify that the above named individuals are in excellent health and appropriate physical condition. I give permission to WLYC to administer first aid and to secure proper treatment or hospitalization for the above named individuals in accordance with WLYC protocol and procedure.

By Submitting this form I agree to indemnify and hold harmless The Wilton-Lyndeborough Youth Center, it’s directors, staff and representatives from any loss, damage, or other disability, however characterized, resulting from injury or damage to above named individuals, resulting directly or indirectly from such members participation or association with The Wilton-Lyndeborough Youth Center, including swimming, games, camps, or other activities.

I/We, the parent(s)/legal guardian(s) for the above named individuals, do hereby agree to the above Indemnification, and I/We further agree that I/We have read and fully understand the terms and conditions, possible implications, and consequences of this Indemnification, and I/We are executing the same freely and voluntarily