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BeachCl

eanUp

Sat. Sept 21, 2013

8:00 am - 1:00pm

atdockweilerbe

ach

Join us at Dockweiler Beach Tower 55 as we do our part to clean the oceanfront.

Earn community service hours, meet new people, and feel great about helping the

environment by keeping our beaches clean!

Tr a n s p o r t a t i o n is a v a i l a b l e a n d l u n ch w i l l b e p r o v i d e d .

www.youthink.org For questions & to RSVP please contact: Carolina @ 323-761-8356; carolina@youthink.oryouTHink is a program of the Zimmer Childrens Museum

Engaging Students in Contemporary Issues and Civic Action Through Art

www.facebook.com/youthinkzimmer

aspartofcoastalc

leanupday

with transportation

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A program of the Zimmer Childrens Museum6505 Wilshire Boulevard #100 Los Angeles, CA 90048Phone: (323) 761-8311 Fax: (323) 761-8990www.youthink.org

Engaging S tudents in Contemporary Issues and Civic Action Through ArtyouTHink Field Trip Permission Form

I, _______________________, parent/ guardian of ___________________________ (student) hereby grantpermission for our son/daughter to participate in the following event:

Destination: Beach Clean-UpDockweiler Beach Tower 5512501 Vista Del MarPlaya del Rey, CA 90293Date: Saturday, September 21st, 2013Departure Time: 8:00 am Return Time: 1:00 pmI understand that transportation will be by: Bus/Shuttle .I understand that adequate and appropriate supervision will be provided. I recognize, however, thatunanticipated situations and problems can arise on any trip, which situations or problems are notreasonably within the control of the supervising youTHink and/or Zimmer Childrens Museum staff(including volunteers). In such instances, I agree that the Zimmer Childrens Museum and the supervising

youTHink and/or Zimmer Childrens Museum staff (including volunteers) are not to be held legallyresponsible in the event of accident or injury and I will hold the Zimmer Childrens Museum and thesupervising youTHink and/or Zimmer Childrens Museum staff (including volunteers) harmless from anycosts, liability, or expenses related thereto.

I also give permission for emergency medical attention to be administered should that be necessary whileon this fieldtrip.

I also give my permission for photos of my child taken while participating in youTHink programs to beused in promotional materials for youTHink and the Zimmer Childrens Museum, which may include aninstitutional video, website, or brochures.

Emergency Contact Information: During the fieldtrip, I can be reached at:If unable to contact parent/ guardian, in case of emergency, please call: (name, relationship and phonenumber)

Parent/Guardian(s) Signature: Date:Print Parent/Guardian(s) Name: _______________ Home Phone Number: _____________Address:_________________________________________ City, State, Zip: _________________________

http://www.youthink.org/http://www.youthink.org/

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6505 Wilshire Boulevard #100 Los Angeles, CA 90048Phone: (323) 761-8987 Fax: (323) 761-8990www.youthink.org

Engaging S tudents in Contemporary Issues and Civic Action Through ArtFormulario de permiso de paseo de youTHink

Yo/Nosotros ________________________ los padres/guardianes de, ,una/un menor, comprendemos el tipo de viaje planeado a:

Destino: Beach Clean-UpDockweiler Beach Tower 5512501 Vista Del MarPlaya del Rey, CA 90293

Fecha: Sabado, 21 de Septiembre del 2013Hora de Salida: 8:00 am Hora de Retorno: __1:00 pmEntendemos que el transporte sera a traves de: Autobus/CamionEntendemos que la supervisin adecuada y apropiada se proporcionar. Reconocemos, sin embargo,que situaciones y problemas imprevistos pueden surgir en cualquier viaje, problemas no razonablementebajo el control del supervisor de youTHink/o Zimmer Childrens Museum (incluyendo voluntarios). Entales casos, nosotros concordamos que ni el Zimmer Childrens Museum ni el supervisante/s ovoluntario/s de youTHink y/o Zimmer Childrens Museum debern ser tenidos legalmente responsable.En caso de accidente o herida, mantendremos al Zimmer Childrens Museum y todo personal de

youTHink y/o el Zimmer Childrens Museum (incluyendo voluntarios) inocuo de cualquier costo,

obligacin, o gastos relacionados a este.

Yo/Nosotros otorgamos permiso de la administracin de cualquier atencin mdica en caso de unaemergencia durante este paseo.

Yo/Nosotros tambin otorgamos permiso de utilizar fotografas tomadas durante este paseo parapublicaciones y materiales promocinales de youTHink y el Zimmer Childrens Museum, al igual quevideos institucionales, pagina de Internet folletos, y ocasionalmente, peridicos.

Durante el paseo, podr ser contactada/o al: Si incapaz de contactar apadres/guardianes, en caso de emergencia, favor de llamar al _____(como estarelacionada esta persona? To? Ta? Abuela? Etc.)

Firma de padre(s)/guardin(es): ____________________________ Fecha: ____________________

Nombre de padre(s)/guardin(es): _____________________ Numero telefnico: ____________________

Domicilio___________________________ Ciudad, Estado, Cdigo Postal: ___________________________

http://www.youthink.org/http://www.youthink.org/