Youth Parent/ Guardian Permission Form for One Hope Youth Programs

Please enter you and your youth's information below for them to participate in One Hope youth programming at the Rose Bowl.

Youth in 7th - 12th grade are welcome to participate in Late Night, Friday Nights from 7-10:30 PM.

Youth in 6th - 9th grade are welcome to participate in MidDay, an afterschool program from 4:45 PM - 6:15 PM on Tuesdays (Youth may participate in games, sports, crafts, cooking or music. Dinner is served.)
There are also MidDay clubs.
Monday 4:45 PM - 6:15 PM is girls only (Volleyball, Girls Club, & more)
Wednesday 4:45 PM - 6:15 PM is Art Club (Photography, Painting, Drawing, Clay Modeling, Bracelet Making, Sewing, & More!)
Thursday 4:45 PM - 6:15 PM is guys only (Flag Football & Soccer Clubs)

Please call or message 918) 954-4147 if you have questions about your child joining a MidDay club.

Youth Information

Youth's Name

Youth's Phone Number

Youth's Address

Grade

Gender

Male Female Prefer not to say

Does your youth have permission to walk home?

Yes Only during the day No

Please upload a current photo of your child that we can use to identify them

Upload (8MB)

School

Birthdate

Does your youth have any health or behavioral concerns we should know about?

Does your youth have an IEP?

Please check the programs and clubs that you are interested in your youth participating in. Youth must complete a brief application to attend MidDay clubs. Contact Jerusha Funderburk at (918) 954-4147 for questions.

On Mondays from 4:45 PM - 6:15 PM for 6th - 9th grade girls: Girls Club & Volleyball MidDay Clubs On Thursdays from 4:45 PM - 6:15 PM for 6th - 9th grade guys: Flag Football and Fitness MidDay Clubs On Tuesday, MidDay from 4:45 PM - 6:15 PM for all middle schoolers On Wednesday from 4:45 PM - 6:15 PM for 6th - 9th graders: MidDay Art Club On Friday from 7 PM - 10:30 PM for 7th - 12th grade: Late Night High School after school Internship

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Parent/Guardian Email

This address will receive a confirmation email

Do you understand that by your youth attending One Hope youth programming, they are agreeing to NOT bring or use weapons or engage in violence?

Yes

Do you understand that by your youth attending One Hope youth programming, they are agreeing to NOT fight or play fight?

Yes

Do you understand that by your youth attending One Hope youth programming, they are agreeing to NOT bring or use drugs, tobacco, vapes, weed, or alcohol?

Yes

Do you understand that by your youth attending One Hope youth programming, they are agreeing to NOT engage in sexual activity, sexual harassment, or viewing/ creating porn?

Yes

Do you understand that by your youth attending One Hope youth programming, they are agreeing to NOT engage in put downs, bullying, harassment, threats, or gang repping?

Yes

Do you understand that by your youth attending One Hope youth programming, they are agreeing to be respectful of the program's schedule and expectations?

Yes

Which races or ethnicities best describe your youth?

White/Caucasian Black/African American Hispanic/Latino Native American Asian/Pacific Islander Other

Is the youth's address the same as yours?

Yes No

If different, what is your address?

Emergency Contact 1

Emergency Contact 1 Number

Emergency Contact 2

Emergency Contact 2 Number

Has the youth ever been found guilty or pled guilty or no contest to a criminal charge of any kind?

Yes No

Has the youth ever had a civil lawsuit alleging actual or attempted sexual abuse or misconduct, child abuse, physical abuse, or financial misconduct brought against him/her?

Yes No

Has the youth ever had any allegations of actual or attempted sexual abuse or misconduct, child abuse or neglect, financial misconduct, intoxication, or use of illegal drugs made against him/her?

Yes No

If you answered "yes" to any of the 3 prior questions, please explain below. (If you answered "no," write N/A.)

Please list anyone we should be aware of who is NOT permitted to pick-up your youth from the Rose Bowl: (If there is no one, write N/A)

I am aware that during participation in activities at the Rose Bowl certain risks and danger may occur. These include, but may not be limited to, the hazards of being in an urban area, the force of nature, and other reasons because of the content of some of the ministries and activities. One Hope will take all reasonable precautions to ensure the safety of participants, but injuries, heat stroke, asthma, allergic reactions, etc, can occur in the normal course of games and sports. In consideration of these ministries and activities, I do hereby assume all risks and will hold One Hope and the employees/leadership/staff harmless from any and all liability, actions, cause of action, debts, claims, and demands of every kind and nature whatsoever which I now have or which may arise from or in connection with my participation in any activities arranged for me by One Hope or occurring at the Rose Bowl. The terms hereof shall serve as a RELEASE AND ASSUMPTION OF RISK for my heirs, executors, and administrators, and for all members of my family. In case of accident or illness, One Hope will attempt to provide first aid and arrange transportation to medical services if needed. I give them permission to authorize medical services or transportation as needed. Cost of medical care beyond first aid is the financial responsibility of the ill or injured person. I assume full responsibility for my health and my child's being such that the activities will in no way aggravate any conditions present. I declare the statements on this form to be true. I also agree that I will follow One Hope policies. I also release all images, videos, quotes, and other media that includes or features me to be used by One Hope as they see fit.

I agree

Youth Parent/ Guardian Permission Form for One Hope Youth Programs

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