In the event that I am unable to be reached and my child requires medical, dental or surgical treatment while in the care of Girls Inc. of Sioux City, I hereby grant permission to the hospital, doctor, dentist or their designees to administer such medical, dental or surgical care/treatment as may be appropriate or deemed necessary. I agree to pay all costs and fees resulting from any such emergency medical, dental, or surgical care/treatment for my child as secured or authorized under this consent. This consent shall remain in effect from the date submitted until such time as my child is no longer attending Girls Inc. of Sioux City.

I hereby grant permission for my child to participate in the afterschool program operated by Girls Inc. I understand that participation may involve physical activities, outdoor play, sports, crafts, and other recreational events. I acknowledge that these activities carry inherent risks of minor or serious personal injury, illness, or property damage, and I voluntarily assume all risks associated with my child's participation.

To the fullest extent permitted by Iowa law, I agree to indemnify, and hold harmless Girls Inc., its directors, officers, employees, volunteers, and agents from and against any and all claims, demands, lawsuits, losses, liabilities, or expenses (including reasonable attorney's fees) arising out of or resulting from my child’s participation in the afterschool program, including but not limited to any property damage or personal injury caused by my child to others or to the property of Girls Inc.

I expressly agree that this agreement is intended to be as broad and inclusive as permitted by the laws of the State of Iowa. If any portion of this agreement is held invalid or unenforceable by a court of law, it is agreed that the remaining provisions shall continue in full legal force and effect.

By providing my contact information, I give Girls Inc. permission to send me updates and program information by email and text message. I understand that message and data rates may apply, and that I can unsubscribe from emails or reply STOP to text messages at any time.

By signing below, I hereby grant permission for Girls Inc. and the school or school district my child is enrolled in while attending Girls Inc. to mutually share and exchange educational and behavioral records regarding my child. I understand that this information sharing is strictly intended to support my child's academic success, safety, and overall well-being by ensuring continuity of care between the school day and the afterschool program. Shared information may include, but is not limited to, attendance, report cards, behavior plans, and specialized accommodation needs. This consent remains valid for the duration of her enrollment in Girls Inc. and may be revoked by me in writing at any time.

I hereby give consent to Girls Inc. of Sioux City to photograph, videotape, or otherwise digitally record and use images and/or sound recordings of my child or children to use in any public media, including radio, television, internet, social media, print or in any of Girls Inc.’s or its partners’ publications, productions, or posts. I understand the intended use of such images and information is solely for the purpose of advertising, marketing, fundraising and/or the promotional and public awareness purposes for Girls Inc. and that identifying information will be limited to first names (if at all). I hereby waive any rights or interest in such images or recordings and forever discharge Girls Inc. (including without limitation all corporate affiliates and officers, directors, trustees, donors, employees, agents and volunteers) from any and all claims, liability, actions, suits, demands, costs, expenses or indebtedness arising out of, related to, or in any way connected with the use of images and materials described herein, and I hereby waive all rights and interest in and to such information and materials.

By submitting this form and with my signature below, I certify that all of the information in this enrollment form is true and complete to the best of my knowledge. I understand that my child must meet the age requirements and must be able to function appropriately in a group setting. I further understand that my child’s enrollment is not guaranteed and is not complete until I have submitted/completed all required forms and she is officially accepted into the program by Girls Inc. I further acknowledge that all fees paid are nonrefundable and that I will be responsible for all fees associated until such time as I officially unenroll her from the program.