2023-24 RYLA Hawai'i Camp Parent Release Form

Download the Code of Conduct & Parent Release Form

Participant's Name: __________________________________________________________________________________________

Participant's School: _________________________________________________________________________________________

Parent(s) / Guardian(s) Release Form

Our son/daughter has discussed the Rotary Youth Leadership Awards (RYLA) program with me (us) and I (we) give my (our) permission to apply for participation in the RYLA Hawaii Camp. 

It is understood that the program may be conducted virtually or in person and supervised by Rotarians and other volunteers. 

I (we) have also reviewed the Program’s Code of Conduct and I (we) agree with them and understand that, to assure the safety and wellbeing of each participant, they will be strictly enforced. 

I (we) further understand that my (our) child is expected to attend the full program and that requests not to take part in any activity or to leave before the end of the program will only be considered by the program staff only based on an exceptional basis such as family emergency, injury, etc. 

I (we) grant permission for the use of camp photographs of my (our) son/daughter by Rotary for RYLA publicity purposes. I hereby release Rotary District 5000, Hawaii Rotary Clubs and all program staff from all liability, including payment for treatment for illness or accidents which may occur.

I have read and agree to the terms in this release.

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Parent/Guardian Name Signature 

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Parent/Guardian Name Signature