Continuing Education
YOUTH ACADEMY ONLINE COURSE WAIVER
STUDENT NAME STUDENT EMAIL STUDENT DATE OF BIRTH
Waiver of Liability
I am the parent/guardian of the above named student who is under 18 years of age. I am familiar with the curriculum and the
activities which take place in the Youth Academy online courses and hereby give consent for the student to participate in the Youth
Academy online courses and assume all risks and hazards incidental to the Youth Academy online courses. I am responsible for the
supervision of the student during his/her participation in the Youth Academy online courses.
I authorize College of DuPage to communicate with this student at the email address listed above and confirm that a parent or
guardian will monitor the student’s use of email and the internet for appropriate behavior as defined in the Student Online Behavior
Agreement section of this document. Additionally, I authorize this email address to be used in communication between students
within the class for group projects or other Youth Academy online course-related communication needs.
I authorize this student to participate in live streaming video and audio communication with College of DuPage employees and other
students registered in Youth Academy online courses.
I authorize this student to use external websites and third-party vendor platforms as they pertain to Youth Academy online courses.
I agree College of DuPage is not liable for information that is retrieved or transmitted via the internet or third-party vendor platforms,
or any unauthorized charges resulting from a student’s use of the internet.
I understand that College of DuPage Youth Academy employees are mandated reporters and as such, any child abuse or neglect
suspected as a result of live video streaming from the student’s home or other communication related to the student’s participation in
Youth Academy online courses will be immediately reported.
I hereby release, waive, covenant not to sue, indemnify and hold harmless the College of DuPage from any and
all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage,
injury, illness, attorney’s fees or harm of any kind or nature to me arising out of student’s participation in the Youth
Academy online courses. This release extends to any claim made by parents or guardians or their assigns arising
from or in any way connected with the aforementioned activities.
The College of DuPage is committed to protecting minors participating in the College courses. if you, as a parent/guardian, have
concerns about any misconduct, please contact the College’s Continuing Education Office at 630 942-2208.
I acknowledge that I am at least eighteen (18) years of age and I have read this document in its entirety and fully understand the
terms of this Waiver.
PARENT/GUARDIAN NAME RELATIONSHIP TO STUDENT
PARENT/GUARDIAN SIGNATURE DATE
*Please note, some Youth Academy online courses may require access to Google Suite applications. For these courses, students will be
given a google account within the College's Google Apps For Education domain. Username and login information will be sent to the
student's email address listed above prior to the start of the course.
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