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SUNIA WAIVERS WEEK A 2024

To participate in SUNIA, we require you to fill out 4 forms:

1) Parent/Guardian Information and Permission Form​ provides details about SUNIA for your parents, including where it is, what we do, and how to contact us. This form also tells us who we should contact in the case of an emergency. Please fill it out and send back the bottom half of the completed form.

2) Expectations for Participation Form​: The expectations for Participation Agreement simply outlines our behaviour expectations -- that you agree to behave respectfully and with common sense -- while out at SUNIA.

3) Release, Waiver, and Assumption of Risk:​ Our Waiver is just a standard waiver which shows that you acknowledge the risks you face by attending SUNIA. Please have this signed and have your parent initial the activities in 2a of form 3 that they give consent for.

4) Wellness Statement:​ Our Wellness Statement is just a way for us to learn more about your health concerns and capabilities, so that we can ensure all of these concerns are well taken care of at SUNIA. If you have no major health concerns, no, you do not need to book an appointment to have your physician sign your form. Only if you have a major health concern should you have your physician fill out Part B of the form and provide explanation. In either case, please have your parent fill out and sign Part A of the wellness statement.

The Seminar on the United Nations and International Affairs (SUNIA)

FORM 1 of 4: Parent/Guardian Information and Permission Form

Please retain a copy of this portion for your information.

A. Information:

a. The Seminar on the United Nations and International Affairs (hereinafter referred to as SUNIA) takes place from 1:00 PM Sunday, August 11th, 2024 to 4:30 PM August 16th, 2024 at and around Bar-V-Nok, Leduc Country, Alberta. The Camp can be reached by telephone at (780) 266-7426. The minimum supervision ratios will be 1 counsellor per 6 participants.

b. Transportation between Bar-V-Nok and Edmonton, Alberta as well as transportation around the Golden Days area to various activities will be in school buses provided by Prairie Bus Lines Ltd. Buses will leave from Edmonton, Alberta at 2:00 PM on August 11th and will return the following Friday, August 16th by 4:30 PM. We ask that students arrive by ​1:00 PM​ on Sunday, August 11th to ensure enough time to pack their luggage on the bus. In previous years we have had trouble with students packing excessively large bags. ​As the buses cannot accommodate excessively large luggage, we ask each student to pack wisely.

c. Activities will include recreational activities such as short hikes, supervised waterfront activities without a trained lifeguard, and large group games and competitions. All counsellors have standard first aid training and first aid equipment is readily available during all activities. Supervision will be provided for all recreational activities and the equipment list in the student information package includes all items that students will require to participate safely in these activities. Other activities include lectures, simulations, and discussion groups as well as a mock United Nations Security Council. Photos and videos of participants may be taken during SUNIA, which may be used for promotional and marketing purposes.

d. The nearest hospital is in Devon, 55.6 km. away. There is an ambulance dispatch and also airlift service to the region. If you have any questions or concerns, please contact Rian Hoyle (Executive Director) at (780) 266-7426.

B. Name of Participant:

Participant has my permission to participate in SUNIA from August 11th, 2023 to August 16th, 2024 with the supervision ratios outlined above.

I have read and understood the information provided with this form. I understand that there is a degree of risk involved in some activities. After carefully considering all the risks involved, and having full confidence that reasonable precautions will be taken for the safety and well-being of my child/ward, I authorize my child/ward to participate in the activity as described above. I agree to provide a completed Personal Health form.

If your child/ward requires medical treatment, your signature on the Personal Health form gives a SUNIA representative authority to take initial steps to secure medical advice and services. You will be contacted as soon as possible. If you are unreachable, the person named in the permission form above will be contacted.

The Seminar on the United Nations and International Affairs (SUNIA)

FORM 2 of 4: Expectation for Participation Form

A. This document outlines expected behaviour during activities. A participant is defined as “any person, adult or child, who is involved in an activity in any capacity.”

B. Participants and/or their parent(s)/guardian(s) must review this form thoroughly before signing it.

  • T​he Seminar on the United Nations and International Affairs (hereinafter referred to as SUNIA) will not tolerate acts of discrimination and/or harassment on the basis of gender, race, national or ethnic origin, colour, age, religion, sexual orientation, family status, or disability.
  • T​he emotional, physical, verbal or sexual abuse of any participant will not be tolerated.
  • P​articipants must follow provincial and municipal laws and regulations and, if permitted, only smoke in the designated smoking area.
  • No alcohol or illegal substances may be brought to or consumed at SUNIA.
  • Any material that may be deemed a “weapon” will be confiscated and the individual will be sent home immediately. The SUNIA Executive Director has the right to define a “weapon.”
  • I​n the event of suspected “banned” materials, the SUNIA Executive Director or their designate may perform a search of belongings for the purpose of confiscation of such banned materials, with the individual and another adult present.
  • T​he privacy of the individual is to be maintained at all times. No person shall disregard another's privacy as it regards to personal belongings, accommodation or hygiene facilities.
  • No participant will engage in acts of criminal or civil disobedience as outlined by the laws of Canada, for example, theft, vandalism, assault, etc.
  • Actions and behaviours that jeopardize the safety of the participant or the group will not be tolerated.

Any violation of this document will be cause for disciplinary measures and will result in discipline that may include the participant being sent home at her/his own or her/his parent’s/guardian’s expense. In the case of expulsion, no portion of fees is refundable.

The SUNIA Executive Director, in consultation with other counsellors, will interpret these expectations. The SUNIA Executive Director has final discretion for ensuring safety by removing or excluding an individual from any activity. Exclusion for reasons of safety may be extended to other activities if the individual has not demonstrated an understanding of risks and appropriate safety guidelines.

I have read the expectations for participation and agree to comply with the above while participating in events/activities. I further understand that any violation of these expectations will be cause for disciplinary measures and if such results in my being sent home, that it is done at my own expense or the expense of parents/guardians.

The Seminar on the United Nations and International Affairs (SUNIA)

FORM 3 of 4: Release, Waiver and Assumption of Risk

Failure to sign this document will result in the exclusion of the participant from activities.

This form is to be signed by custodial parent(s) or guardian(s) of a minor child or by participants who are provincial age of majority.

Parent(s)/guardian(s): Review the information below and the risks and safety management strategies listed on the Parent/Guardian information form. ​​Initial all the activities in 2(a) that you are consenting to your child/ward’s participation in, and then sign the form at the bottom.​​ If you are completing the waiver online, click "adult" or "minor" as applicable at the bottom of the waiver and the list of activities will appear—please check off the ones you are providing consent for. Your child/ward will not be permitted to participate in those activities for which you have not initialled.

I (we) hereby acknowledge and agree to the following in consideration of Participant being permitted to participate in the activities of the Seminar on the United Nations and International Affairs (hereinafter referred to as SUNIA), at and around Bar-V-Nok, Leduc County, Alberta, from August 11th, 2023 to August 16th, 2023 (hereinafter referred to as the Program).

  1. ​I (we) do hereby release SUNIA, its members, officers, directors, and volunteers from all liability, claim, causes of action of any kind whatsoever in respect to all personal injuries, loss of life or property losses which our child/ward/self may suffer while participating in the Program.
  2. ​And I (we) do hereby acknowledge and agree that the adventurous activities listed below may be dangerous and expose my (our) child/ward/self to risks and hazards (initial activities to show consent for participation):
  3. That I (we) hereby authorize SUNIA to publish photographs and videos taken of me (my child/ward) during the above dates for use in print, online, and video-based marketing materials as well as other SUNIA publications.
  4. ​That I (we) freely and voluntarily assume all the aforesaid risks and hazards as noted on the attached Parent/Guardian Information form for my child/ward/self.
  5. ​That I (we) have carefully read this Release, Waiver and Assumption of Risk agreement, that I (we) fully understand same, and that I am (we are) freely and voluntarily executing same.
  6. That I (we) understand clearly that by signing this Release I (we) will forever waive the right to bring a legal claim against SUNIA, its members, officers, directors, or volunteers with respect to any matter arising from participating in the Program.

Note: When only one parent signs to indicate consent, they do so in good faith and is presumed to be acting with the consent of the other legal parent/guardian.

The Seminar on the United Nations and International Affairs (SUNIA)

FORM 4 of 4: Wellness Statement

Note: If you are completing the waiver online, click "adult" or "minor" as applicable at the bottom of the waiver and the health information form will appear.

A. T​he information on this form may be used by representatives of the Seminar on the United Nations and International Affairs (hereinafter referred to as SUNIA) to administer or authorize appropriate health care or medical attention for the participant, if needed.

B. T​he health information in this wellness statement will be used only by SUNIA Staff. Due care will be taken to preserve the privacy of participants in regards to their health information.

C. T​he Wellness Statement must be completed and signed by a physician if, within one month of the date of SUNIA, the participant has been treated by a physician for an illness or injury that will have an impact on participation (e.g., fracture, recent diagnosis of diabetes, operation, pneumonia, etc.)

Physical requirements for participating in the SUNIA program:

  • Able to move short distances between buildings (50-400 m) several times daily over uneven surfaces (gravel, small roots, etc.)
  • Able to do hikes of a maximum of 8 km on well-established trails with some steep sections.
  • Able to participate in group-wide games/initiative challenges.
  • Able to tolerate allergens and other natural hazards commonly encountered in an outdoors/camp setting.

I understand that my child/ward will be expected to safely and fully participate in SUNIA to the best of his/her ability and with minimal physical assistance. I further understand that if it is deemed by the Executive Director of SUNIA, in consultation with other counsellors, that my child/ward’s participation has posed a safety risk to him/herself or others in the group, I will be consulted and will be responsible for arranging transportation home for my child/ward at my expense.

 

 

 

 

 

 

 

Please select who will be participating...
AdultMinor
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First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Activities - Select activities to show consent for participation *
Supervised waterfront activities (e.g. swimming, canoeing) without a trained lifeguard
Hikes of 8km or less
Large group games and competitions
None of the Above

Wellness Statement: Section A 

Please assess participation based on the following questions: 

    Does the participant have any potential health risks, illnesses, or injuries that would make it difficult for them to participate in the outdoor (e.g. hiking for 8 km) or indoor (public speaking) components of SUNIA? (If yes, specifics of any necessary care must be detailed below).*
    No
    Yes
    Does the illness, injury, or other health concern limit the ability of the participant to safely engage in the activities of SUNIA?*
    No
    Yes
    Will the illness, injury or health concern affect the health or safety of other participants?*
    No
    Yes
    Could hospitalization or ongoing professional treatment be required during SUNIA?*
    No
    Yes

    Wellness Statement: Section B

    Only complete this form if you have answered yes to any of the questions in Section A. If you are unsure if you will need a physician's note, please contact our registrar at (825) 440-7658. 


    Nature of illness or injury:

    When did it occur:

    Ongoing treatment:

    Potential problems that counsellors may need to be aware of:
    First Participant's Signature*
    Participant's Address
    Address Line 1:*
    Street address, P.O. box, company name, c/o
    Address Line 2:
    Apartment, suite, unit, building, floor, etc.
    Country:*
    City:*
    State/Province:*
    Zip/Postal:*
    Parent or Guardian's Email Address

    Email
    A signed copy of this waiver will be sent to the email address you provide.
    Emergency Contact

    First Name*

    Last Name*

    Emergency Contact's Phone Number*
    Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


    By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
    Parent or Guardian's Name

    First Name*

    Last Name*

    Relationship*

    Phone*
    Parent or Guardian's Date of Birth*
    Parent or Guardian's Information
    Activities - Select activities to show consent for participation *
    Supervised waterfront activities (e.g. swimming, canoeing) without a trained lifeguard
    Hikes of 8km or less
    Large group games and competitions
    None of the Above

    Wellness Statement: Section A 

    Please assess participation based on the following questions: 

      Does the participant have any potential health risks, illnesses, or injuries that would make it difficult for them to participate in the outdoor (e.g. hiking for 8 km) or indoor (public speaking) components of SUNIA? (If yes, specifics of any necessary care must be detailed below).*
      No
      Yes
      Does the illness, injury, or other health concern limit the ability of the participant to safely engage in the activities of SUNIA?*
      No
      Yes
      Will the illness, injury or health concern affect the health or safety of other participants?*
      No
      Yes
      Could hospitalization or ongoing professional treatment be required during SUNIA?*
      No
      Yes

      Wellness Statement: Section B

      Only complete this form if you have answered yes to any of the questions in Section A. If you are unsure if you will need a physician's note, please contact our registrar at (825) 440-7658. 


      Nature of illness or injury:

      When did it occur:

      Ongoing treatment:

      Potential problems that counsellors may need to be aware of:
      Parent or Guardian's Signature*
      Electronic Signature Consent*
      By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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