I HEREBY CONSENT to the use, publication or display by or on behalf of the AGGBGC of any photographs and any reproduction thereof or any video or voice recordings in which my minor child (children) may be portrayed or identified. I understand that the AGGBGC may use, publish and display such photos, reproductions, videos, or voice recordings thereof, in whole or in part, for any promotional purpose. I waive all claims for any compensation for such use. Sources of publication or broadcast may include newspapers, magazines, TV or radio stations, promotional publications, web sites, Facebook, Twitter, exhibits, internal or external newsletters, e-newsletters, or any other informational material prepared by the AGGBGC. The AGGBGC may use pictures, films, or recordings in any AGGBGC information materials or in response to requests from news media or outside agencies, which depict AGGBGC programs and membership activities at the AGGBGC. I waive all claims for any compensation for such use. Thereby, I give permission to AGGBGC to use my minor child’s (children’s) first and last name, grade level in school, school name and location, and any stories associated with their participation in the AGGBGC program to the media.
I, the parent/guardian of the minor child (children) on this application, request admittance to membership in the A.G. Gaston Boys & Girls Club, Inc. (hereinafter “AGGBGC”) and I will be responsible for any damage or destruction that his/her/their actions may incur. I understand that membership dues are non-refundable. It is expressly understood and agreed by the undersigned that the A.G. Gaston Boys & Girls Club is not liable for loss of property or injury. It is understood that the A.G. Gaston Boys & Girls Club will not be liable for your child leaving the building and /or grounds without permission. It is agreed that the Parent or Guardian will not hold the A.G. Gaston Boys & Girls Club responsible for the welfare or whereabouts of the member. If the Parent or Guardian does file a complaint against the Club, the Parent or Guardian agrees to pay for A.G. Gaston Boys & Girls Club legal fees.
I agree to not hold the AGGBGC or its representatives responsible for injuries or accidents in connection with the Club’s activities and authorize the Club to administer first aid in case of accident. I also give the Club permission to authorize and obtain permission for emergency treatment.
As a member(s) of the AGGBGC, your child (children) will have access to the Internet. While precautions are being taken, it is possible he/she/they may access inappropriate sites. The AGGBGC has rules and consequences for such behavior; however, we will not be responsible for the consequences of such access.
I understand the AGGBGC is not responsible for lost or stolen items. I further understand the Club is not a day-care center and does not assume responsibility for my child (children) if he/she/they leave the Club at any time during hours of operation. I have received the Parent Handbook and attended a required membership orientation, agree with its content, discussed the rules with my child (children) and accept responsibility for all fees associated with my child’s (children’s) membership in AGGBGC.
AGGBGC welcomes your child to come to the Club anytime during our operating hours; however, each child must be picked up from the Club at or before closing. After a 5-minute grace period, a $10.00 late fee will be charged for the first five minutes and $1.00 per minute thereafter. Fee must be paid before the member returns to the Club.
The above list is not all-inclusive – traditional Club rules apply. Please see the Member Handbook.
