By initialing this agreement, I represent that I am the parent/guardian, that I am over the age of 21, that I have read the foregoing, and fully understand the contents thereof, that the consideration that I have received for this Agreement, Release, and Waiver is fair and equitable, and that I hereby give this Agreement, Release, and Waiver of my own free choice. This Agreement, Release, and Waiver shall ensure to the benefit of the successors, assigns, licensees, and legal representatives. I have read the completed application and I understand the policies and procedures of the Boys and Girls Clubs of Laurens & Johnson Counties. I request that my son/daughter be admitted into membership and I grant permission for my child to participate in current and future programs. I have explained the rules to my son/daughter and agree that BGCLJC/DHS/DFCS/Georgia Alliance will not be responsible for any accident to him/her while on the premises of BGCLJC or while engaged in any of its activities away from BGCLJC.