I/We  are enrolling in Your After School program(s), hereby authorize and give consent to Your After School to release my/our child from Your After School without parental supervision and hereby consent, acknowledge and allow my/our child to walk home from Your After School without parental or Your After School supervision.

I/We acknowledge and affirm that my child has, in my/our opinion, the maturity and physical ability necessary to undertake walking home without parental or Your After School supervision. 

I/We further acknowledge that walking home unsupervised may be dangerous for my/our child.

I/We, on behalf of ourselves, our family, heirs, personal representative(s), and/or assigns, do hereby expressly and specifically assume any and all risk of injury, illness, death or property damage of any kind resulting from allowing my/our child to walk home from Your After School and waive, release, absolve, indemnify, and agree to hold harmless Your After School, its employees, agents, independent contractors, the organizers, sponsors, supervisors, and participants in the Your After School program for any claim arising out of injury to my/our child or damage to any property due to my/our election to allow my/our child to walk home from school without parental or Your After School supervision.

I/We affirm that I am/we are the parent(s) or legal guardians of the above-named student and have the requisite authority and right to execute this consent and waiver form without any other person or third party’s additional consent or approval.

This waiver and consent will remain in effect as long as my/our child is enrolled in the Your After School program(s) or until I/we notify Your After School in writing that I/we revoke this authorization.

As of October 1, 1993, Connecticut State Law requires ALL BICYCLE RIDERS UNDER THE AGE OF 14 TO WEAR HELMETS. Students are to park and LOCK their bicycles in racks located on the school grounds. Bicycles are to be walked to and from the bike rack.