Youth Application

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Parent/Legal Guardian 2

Alternate Emergency Contact

Grand Canyon Youth will only contact an Alternate Contact after first attempting to connect with the parent(s)/guardian(s).

Participant Health Information

As parent/guardian, GCY relies on you to provide thorough and accurate information about your youth’s health history. Your youth is traveling to a wilderness area and may be more than 24 hours away from definitive care. It is important that you advise GCY of any changes to your youth’s medical condition prior to their expedition. GCY guides have wilderness first aid training (WFR), but they are not medical professionals. The confidential information provided in this form is shared only with applicable parties and program staff.

In the event of an injury or illness requiring medical care for the participant, I hereby give permission and consent to attending medical personnel, Grand Canyon Youth’s officers, directors, employees, representative agents, volunteers, contract individuals and all other persons or entities associated with it, to render any and all necessary treatment, including administration of epinephrine.

AGREEMENT TO ASSUME ALL RISKS; RELEASE OF LIABILITY/ AGREEMENT NOT TO SUE & TO INDEMNIFY

Please read this contract carefully. It releases Grand Canyon Youth from liability and waives certain rights.

In consideration of being permitted to participate in an outdoor recreation experience with Grand Canyon Youth, Inc., an Arizona nonprofit corporation (hereinafter “GCY”), I, the Participant, (or if the Participant is under the age of 18, I, on the Participant’s behalf) understand, acknowledge, and contractually agree as set forth below (the Agreement):

1. Acknowledgement of Dangers and Risks:

I understand, acknowledge, and agree that participating in an outdoor recreation experience facilitated by GCY, which may include boating, camping, hiking, and related transport by or with GCY (hereinafter collectively and individually the “Activity”), can be HAZARDOUS AND INVOLVE THE RISK OF SERIOUS INJURY AND/OR DEATH. I understand, acknowledge, and agree that participating in the Activity involves certain inherent dangers and risks that cannot be eliminated, altered, or controlled by GCY, the presence of which are integral to the adventurous nature of the Activity. I contractually agree that the following dangers and risks that could cause physical or emotional injury or death are inherent to the Activity, but that the list of inherent risks is not exhaustive – I understand and acknowledge that there are many other dangers or risks associated with the Activity not listed below: a) Risks associated with boating and being around or in water, including: falling into water; water immersion including drowning; jolting or jarring resulting in contact with hard objects including natural features, boating equipment, and the body parts of others; injurious contact with other watercraft, rocks, the bank, or other natural or man-made objects; capsizing or flipping boats; becoming tangled in ropes; getting trapped or caught beneath an overturned boat; being separated from watercraft; foot entrapment; trapped limbs; striking and/or becoming entangled with tree strainers or other objects in or under the water; being trapped by a hydraulic, swift current, undercut or other river feature; changing or unexpected natural or man-made water conditions; hazardous river or lake conditions, including whirlpools, strong currents, eddy lines, large waves, and shallow water; injury resulting from jumping from heights including from cliff or rock jumping; injuries caused by misjudging water depth or current; equipment malfunction; injury resulting from improperly rigged gear or equipment; failure to understand and follow guide instructions; prolonged exposure to cold water; hypothermia; physical over-exertion; mental or physical shock; slipping, tripping or falling around or from boats; burning associated with hot surfaces and sun; and errors in guide judgment, or lapse in guide skill; b) Risks associated with transport in a motor vehicle, including: all commonly understood risks of riding in a vehicle, including crashes; slipping, tripping or falling in or from vehicles; risks associated with riding in a vehicle in remote terrain on backcountry or 4-wheel drive roads; and lapse in driver judgment or skill; c) General risks associated with participating in an outdoor recreation experience and the Activity, with other participants and relying on guides and/or staff, including: slipping, tripping or falling; steep and/or rough trail and off-trail conditions; falling from steep terrain or cliff edges; irregular or obstructed footing; allergen exposure; exposure to various dangerous or diseased wildlife or insects, including but not limited to bears, bees, wasps, ants, spiders, ticks, bats, rodents, scorpions, venomous reptiles, or snake stings or bites; dangerous contact with domestic animals; exposure to dangerous or poisonous plants; harmful or toxic algal (algae) blooms; water and land pollution and debris; falling trees, rocks, or other natural or man-made objects; moving objects associated with extreme weather; changing weather, dangerously cold and hot temperatures, wind, hail, snow, lightning, heavy rain, storms, and other adverse weather conditions; wildfire; flash flood; earthquake; landslides; rock-fall; mudslides; dangerous water crossings; discharge of weapons in or near the area of Activity; wildfire or uncontrolled camp or kitchen fire; burns or burning associated with campfires, cook stoves, hot food and/or beverages, hot surfaces, and sun exposure; exposure to food allergens; exposure to food-borne, water-borne, vector-borne, or airborne bacteria, virus, or pathogens; flying man-made objects such as balls, frisbees, gear, or equipment; all manner of outdoor injuries or ailments including head or brain injury, spinal injury, paralysis, broken bones, burns, internal injury, sickness or disease; exacerbation of the Participant’s own health condition(s); hypothermia, sunburn, frostbite, heatstroke, dehydration, hyponatremia, and altitude sickness; physical or psychological shock or trauma; overexertion; strenuous activity; fatigue; dizziness or disorientation; lack of access to immediate medical care due to remote location; inadequate or incorrect medical care; poorly executed or failed rescue attempts; dangerous contact with rescue vehicles, boats, or aircraft; failure or lack of communication equipment; inadequate or malfunctioning equipment; lack of or inadequate shelter; getting lost; mentally or physically unstable, negligent or criminal trip participants; lack of access to weather alerts and other warnings or information; errors in guide or staff judgment or lapse in guide or staff skill; and mental, physical, or emotional injury or distress from exposure to any inherent risks associated with the Activity. I understand that GCY has done its best to list the known risks of participating in the Activity, but agree that I have the right, obligation, and opportunity to research and verify the risks of participating in the Activity.

There are inherent risks involved with participating in the GCY expedition. It is a parent’s/guardian’s responsibility to become informed about these risks and make a deliberate choice in supporting your youth’s participation. Many of the known risks are listed in the liability waiver that is a part of this application, but parents/guardians have the affirmative and final obligation to become informed about GCY expeditions prior to allowing their youth to participate.

• * We rely on parents’/guardians’ judgment to not involve their youth in our expeditions if they believe the youth could pose a behavioral risk to themselves or others. Knowing disregard of this potential risk may result in parent/guardian liability.
• * GCY is a private, nonprofit organization. We have the right to exclude any participant who we believe, at our sole discretion and for any reason, could pose a risk to themselves or other participants beyond our ability and resources to manage within an appropriate standard of care. All participants must meet GCY’s “Essential Eligibility Criteria.” (Can be found on our website) Parents/guardians must review this document and hereby certify that their youth meets the stated criteria.
• * If Trip Leaders and/or Trip Coordinators have cause to believe any participant is unwilling to follow directions, safety rules, the law, or represents an unacceptable risk to themselves or to others, that participant may be separated from the group and evacuated from the expedition at the expense of parents/guardians. Participants may be held legally responsible if they break any law while participating in the GCY expedition.
• * Parents/Guardians hereby agree to talk with their youth about the requirements of participation in a GCY expedition, stressing the importance of following all expectations and safety practices set by GCY.
• * Parents/Guardians should encourage their youth to communicate any concerns immediately with adult supervisors on the expedition.

I have read and acknowledge the information and requirements in this form and consent to my youth’s participation in a GCY expedition knowing of all above risks. My youth fully understands, and they will adhere to all expectations outlined in the personal contract. My youth may also participate in all activities pertaining to GCY, including fundraisers, community service projects, transportation, and river expeditions during their involvement. Breach of this contract may lead to participant’s dismissal from the expedition.

I hereby grant Grand Canyon Youth, its co-sponsoring organizations, partners, media representatives, employees, volunteers, and expedition participants the right to photograph, record, or film my youth’s participation in a Grand Canyon Youth expedition without recompense. This includes the right to use photographs, audio, or film in promotional, documentary, online, print, digital, and media outlets.

For everyone's privacy, we ask that anyone who receives images does not share/post images of youth other than their own.

Please help us understand the circumstances that demonstrate your financial need. We appreciate your honesty.

I hereby certify that all provided information is accurate and complete. I am requesting only what we need and I understand that funds are limited. I understand that completing this application form is not a guarantee of being awarded financial aid.