LIABILITY RELEASE FOR ALL NYCC PROGRAMS: I understand that, while National Youth Community Center (NYCC) is committed to the thorough supervision of all activities, there are inherent risks to attendance at any program. I understand and assume all associated risks of personal injury or loss, bodily injury (including death), and damage to, loss, or destruction of any personal property occurring in connection with or arising out of Participant Student's participation in a NYCC program. I hereby release, discharge, and hold harmless NYCC and its members, officers, agents, employees, and any other persons or entities acting on their behalf from any and all claims, demands, costs, expenses, and causes of action, whether in law or equity, arising out of or connected in any way with any loss, bodily injury, disability or other harm arising from participation in an NYCC program. I authorize, in a medical emergency, after reasonable effort has been made to notify me, that NYCC staff may seek emergency assistance and medical treatment for Participant Student at the parent/guardian's expense. I certify that I have adequate insurance to cover any injury or damage that Participant Student may cause or suffer while participating, or I agree to bear the costs of such injury or damage myself.

PHOTO RELEASE: Participants in NYCC programs are sometimes photographed and videotaped for use in promotional and educational materials. I understand that such audio, video, film and/or print images of Participant Student may be edited, duplicated, distributed, reproduced, broadcasted, and/or reformatted in any form and manner without payment of fees. Please note: NYCC reserves the right to remove any student from the program if s/he displays any behavior that is harmful to others and/or disruptive to our program.

I hereby apply for a membership to join NYCC, and I agree to abide by the terms and conditions as provided by NYCC. I understand that any violation of the aforewritten terms and conditions may result in the revocation of my membership or any access to NYCC programs and/or property and that disciplinary action may be taken. Furthermore, I give my consent to NYCC to collect, process, and use my personal data taken for the purposes of processing my application and for any other use necessary for the programs or any activities at NYCC, including promotional and educational purposes.