Carson Future Unlimited

2019 City of Carson Youth Conference

"Dreamers are Achievers"

Carson All America City Parks Make Life Better!

Fields with * are required.
First Name*:
Last Name*:
 
Address:
 
Home Phone:
Cell Phone*:
Email*:
 
Park/Affiliation:
Date of Birth:
Age*:

Parent/Legal Guardian Name*:
Phone*:

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For more information, please call (310) 847-3570.

We will see you Friday, May 17, 2019 at:
Congresswoman Juanita Millender-McDonald
Community Center in Carson
801 East Carson Street, Carson
5 p.m. – 10 p.m.
Please arrive early for Check in!

How to Register:

  1. Online at https://payment.carson.ca.us/youthconference2019/
  2. Drop off application at your local park or mail to:
    Kenny Harris/Isaac Gardner
    Youth Conference
    Recreation and Human Services Division
    2400 East Dominguez St., Carson, CA 90810

I hereby certify that I am the parent and/or legal guardian of the aforementioned child, and that I am entitled to his or her custody and control, and I do hereby give my permission for said child to participate in:

The 27th Annual Youth Conference on Friday, May 17, 2019, from 5 p.m. to 10 p.m., at the Juanita Millender–McDonald Community Center, 801 East Carson Street in Carson.

In consideration of the acceptance of my (child's) application for participation in This event, I for myself, my heirs, executors, administrators and assigns, hereby waive, release and discharge any and all claims for damages for death, personal injury or property damage which I may have, or which may hereafter accrue to me , as a result of my (child’s) participation in this program, and I further agree to indemnify and hold harmless the City of Carson and its officers, agents, and employees from any liability or claim or action for damages which in any way arises out of my (child's) participation in this program even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above.

I FURTHER UNDERSTSAND THAT SERIOUS ACCIDENTS OCCASIONALLY OCCUR DURING SOME EVENTS, AND THAT PARTICIPANTS IN SUCH ACTIVITY OCCASIONALLY SUSTAIN SERIOUS PERSONAL INJURIES AND/OR PROPERTY DAMAGE AS A CONSEQUENCE THEREOF. KNOWING THE RISK OF EXCURSIONS, I HEREBY AGREE TO ASSUME THOSE RISKS AND TO RELEASE AND HOLD HARMLESS THE CITY OF CARSON, ITS OFFICERS, AGENTS, AND EMPLOYEES FROM ANY LIABILITY TO ME OR MY HEIRS OR ASSIGNS FOR DAMAGES.



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