I hereby confirm that my child has my permission to become an active member of the Youth Group of Zeta Phi Beta Sorority, Incorporated, under the auspices of the local chapter. This authorization is granted for participation in activities, programs, and events associated with the youth auxiliary of Zeta Phi Beta Sorority, Incorporated. I certify that I am the child’s parent or legal guardian and have the authority to provide this consent.

I hereby confirm that my child has my permission to attend activities for the Youth Group of Zeta Phi Beta Sorority, Incorporated. It is my understanding that these activities, which are taken under the auspices of Zeta Phi Beta Sorority, Incorporated, will be supervised by competent members who will travel with the group.

I hereby release and hold harmless Zeta Phi Beta Sorority, Incorporated, its local chapter, agents, representatives, and employees (collectively and individually referred to as Zeta Phi Beta Sorority, Incorporated) from any and all liability which may arise in connection with my participation, or my child's participation, in any and all activities sponsored by Zeta Phi Beta Sorority, Incorporated, its local chapter, or any other offices, departments, or organizations associated with Zeta Phi Beta Sorority, Incorporated. Such activities so sponsored shall be referred to as Programs.

This release shall include, but is not limited to, potential liability from accidents or injuries that may occur in connection with participation in the Programs or potential liability from the content of any and all Programs.

Furthermore, I agree to indemnify Zeta Phi Beta Sorority, Incorporated, including its local chapter, from any suit, claim, or other action brought by any parent (whether biological, adoptive, custodial), guardian, or family member of any youth participating in any Program, on account of or in connection with my participation or my child's participation in any and all Programs.

I understand that Zeta Phi Beta Sorority, Incorporated is not responsible for determining whether the content of any Program is suitable for the participants; such determination shall be made solely by the participant or their parent/guardian. I declare that I have read the terms of this Release in their entirety, fully understand them, and voluntarily accept each and every term of this Release.

I/We are the parent(s) or guardian(s) of the child named in this application. After having fully considered the possibilities of harm arising out of or in connection with reasons of illness, injury, accident, or death incurred or suffered by our child’s participation during the meetings, activities, events, trips, or service projects of the Youth Group of Zeta Phi Beta Sorority, Incorporated, I/We, as the parent(s) or guardian(s), accept full responsibility for any and all injury to our child which may occur during travel, participation in activities, and any other time during the scheduled and planned events.

I/We certify that our child is in good health and free from any disability that would make participation in the program or conference inadvisable.

As the parent or legal guardian, I request that in my absence, the above-named child be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine, Doctors of Dentistry, or other such licensed technicians or nurses, to perform any diagnostic, operative procedures, or x-ray treatment of the minor.

I have read this release and indemnification agreement and understand its meaning. This release is intended to bind my heirs, representatives, successors, assigns, and administrators.

I grant Zeta Phi Beta Sorority, Incorporated the unlimited right to use and/or reproduce photographs or likenesses in any legal manner for the internal or external promotional and informational activities of Zeta Phi Beta Sorority, Incorporated. I also agree to allow my child to be interviewed and/or photographed by representatives of the external news media in relation to any and all coverage of Zeta Phi Beta Sorority, Incorporated in which she is involved. I further agree to allow my child’s work and/or photograph to be published on the Zeta Phi Beta Sorority, Incorporated national and local chapter website, internet pages, and publications. I understand that by signing this release, I waive any and all present or future compensation rights to the use of the above-stated material(s).

We understand that sometimes things happen, and you must cancel. Written requests for registration refunds must be received on or before the close of registration. Zeta Phi Beta Sorority, Inc. will maintain $50.00 as an Administrative Fee.

We understand that circumstances may arise requiring you to cancel. If you need to cancel, a written request must be received on or before the close of registration. Please note, your registration is complimentary, and no refund will be issued.