• Boys' and Girls' Day Out 2026

    Called to Duty: Phase II- Prepared to Stand. Ready to Serve.
  • Format: (000) 000-0000.
  • List the names of all students attending. If adding more than one child you must click add a row. *
  • PLEASE READ THIS SECTION VERY CAREFULLY!!

    1. Participation Consent
    I, the undersigned parent or legal guardian of the above-named child, grant permission for my child to participate in the Boys’ and Girls’ Day Out event hosted by the Florida-Cocoa Organization. I understand that my child will engage in various activities and conversations, including but not limited to team-building exercises, knowing your identity, and human trafficking topics which may or may not include: peer pressure, comparison, social media, healthy relationships, boundaries, sex, wise decisions, online saftety, safe vs unsafe secrets and conversations, identifying trusted adults, manipulation, mental, recognizing red flags, stranger danger, and more (age appropriate).

    2. Emergency Medical Care Authorization
    In the event of a medical emergency, I authorize the Florida-Cocoa Organization staff, leaders, and volunteers to seek necessary medical attention for my child. I understand that every reasonable effort will be made to contact me or the emergency contact before administering any treatment. I assume full responsibility for any medical expenses incurred as a result of any necessary medical treatment. I also understand that Florida-Cocoa Organization staff, leaders, and volunteers are not certified to give out any medications unless we have written authorization and medication is prescription and in the original bottle with all information from the pharmacy (medication in ziplock bags and unidentified medications will not be authroized).

    3. Photo & Video Release
    I give permission for my child to be photographed or recorded during the Boys’ and Girls’ Day Out event. I understand that these images and recordings may be used for promotional materials, social media, presentations, or other official purposes related to the Florida-Cocoa Organization. I release all rights to any images or footage taken.

    4. Liability Waiver & No-Fault Agreement
    I acknowledge and understand that the Florida-Cocoa Organization, its staff, volunteers, and event partners will not be held responsible for any injuries, accidents, or losses that may occur during this event, except in cases of proven negligence. I agree to release and hold harmless the Florida-Cocoa Organization, its directors, affiliates, and volunteers from any claims, damages, or liabilities arising from my child’s participation in this event.

    By CLICKING YES, I acknowledge that I have read and understood the terms of this waiver and consent form. I confirm that I am the legal guardian of the participant and give my full consent for their participation under these conditions.

    5. Immediate Pick-Up Policy
    I understand that if at any time Florida-Cocoa Organization staff or volunteers determine that my child must be picked up immediately—due to illness, behavioral concerns, or other urgent matters—I am responsible for arranging pickup as soon as possible. If I or my designated emergency contact cannot be reached, or if pick-up does not occur within a reasonable timeframe, I acknowledge that law enforcement or child protective services may be contacted to ensure the safety and well-being of my child.

    By signing this agreement, I confirm that I understand and accept this policy.

  • I authorize the Florida- Cocoa Organization staff, leaders, and/or volunteers to give medication if necessary and will comply with all instructions previously given.*
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