SARATOGA COUNTY DEPARTMENT OF AGING AND YOUTH SERVICES SPONSORS THE CORINTH SUMMER ADVENTURE PROGRAM 2024

YOUTH SPORTS AND SPORTS EDUCATION OPPORTUNITY
REGISTRATION FORM – CORINTH SUMMER ADVENTURE PROGRAM

Aging SummerAdventure RegistrationForm

Please list any pertinent medical information (including those requiring maintenance meds)

Additional Information (not required but helpful information) IEP, Special needs, disabilities, physical limitations, aide required, anxiety, shy, etc.

Parent/Guardian Contacts: (Parent/Guardians are always called first before emergency contact)

Other people authorized to pick up youth (Must be 16 years or older and required to show ID)

PLEASE READ THE FOLLOWING CAREFULLY.  BY SIGNING BELOW, YOU AGREE TO THE FOLLOWING WAIVER.

I hereby grant permission for my child to participate in the Youth Sports and Sports Education – Regional Summer Adventure Program. I fully understand and acknowledge that there are inherent risks and dangers associated with my child’s participation in the Youth Sports and Sports Education Program. I also recognize the difficulties and challenges involved in indoor and outdoor sports and recreation programs, and that my child is sufficiently physically and psychologically fit to participate and has not been advised otherwise by a physician.

I agree to indemnify and hold harmless the County of Saratoga, the Towns of Northumberland, Saratoga and Village of Schuylerville, the Greater Schuylerville Youth Center, the South Glens Falls Central School District, and businesses participating in the Youth Sports and Sports Education Program, its employees, and personnel from any and all claims, causes of action, liability for injuries or damages which may arise as a result of participating in this program, including but not limited to reasonable attorney’s fees and the costs and disbursement of any legal actions and extending to employees, personnel, volunteers, instructors, etc. in responding to any emergency and/or medical situation or event.

Furthermore, I understand that during the event photographs may be taken and published through social media pages or affiliated websites. Some photographs may capture your child’s participation, directly or indirectly. I grant permission to use photos taken which may involve my child for publication on said platforms.

Select 1st & 2nd choice – leave blank if you DO NOT want to attend that week or activity

Northumberland Town Hall, 17 Catherine St., Gansevoort, NY
Transportation provided from the Greater Schuylerville Youth Center (GSYC) at 9:40am; returning at 2:50pm

Waivers

Adirondack Adventure treetop requires a completed waiver form

The Revolution Rail Bike requires a completed waiver form

Transportation provided from GSYC at 9:15am, Northumberland Town Hall (NTH) at 9:30am; returning to NTH at 1:25pm and GSYC at 1:45pm

Waivers

Adirondack Adventure rafting requires a completed waiver form

The Revolution Rail Bike requires a completed waiver form

Transportation provided from GSYC at 9:15am, NTH at 9:30am; returning to NTH at 1:25pm, GSYC at 1:45pm

Waivers

Adirondack Adventure rafting requires a completed waiver form

Adirondack Adventure treetop requires a completed waiver form

Transportation provided from GSYC at 9:15am, NTH at 9:30am; returning to NTH at 1:15pm, GSYC at 1:30pm

Waivers

Adirondack Adventure tubing requires a completed waiver form

Transportation provided from GSYC at 9:15am, NTH at 9:30am; returning to NTH at 1:45pm, GSYC at 2:00pm

Transportation provided from NTH at 9:15am, GSYC at 12:00; returning to NTH at 12:30pm, GSYC at 3:15pm

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