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* 1. Member name

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* 2. Member Grade in Fall 2025-2026

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* 3. Parent name

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* 4. Parent phone number

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* 5. My child has the following medication on file with the Boys & Girls Clubs.

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* 6. Field Trip

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* 7. I understand that Field trips are first come first serve. I understand that my member must display good behavior at the Club without any incidents to participate in Field Trips. I understand that I will receive a charge on my ProCare Account if approved and a message on ProCare if waitlisted. If you are waitlisted, please send member with their club shirt just in case we have a last-minute cancellation.

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* 8. I understand that once I have been approved, I will have 24 hours to make my payment to lock in my spot. I understand that failure to pay will result in forfeiture of spot.

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* 9. I understand and acknowledge that in order to participate in a field trip activity, I and my son/daughter agree to assume all liability and responsibility for any and all potential risks, or injuries, which may be associated with participation in such activity.  My child is mentally and physically fit, capable, and willing to participate in this activity without any limitations.
I hereby release, indemnify, and agree to hold harmless Boys & Girls Clubs of Tustin and its agents and representatives free from any and all liability arising out of, or in connection with, my child’s participation in any field trip activity.
Boys & Girls Clubs of Tustin has my permission to select a physician in case of emergency, and treatment may be given should the parent or authorized physician be unavailable. I will assume full responsibility for all uninsured medical costs incurred in that situation.
Club members attending outside activities with Boys & Girls Clubs of Tustin are expected to behave in a positive manner, consistent with the goals and objectives of Boys & Girls Clubs of Tustin. Other undesirable behavior will not be tolerated and will result in suspension from further trips.

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