I understand that Samantha's Purpose and No Limits Coffee Shop will be taking photographs or videos during Saturday Breakfast Club for use in Samantha's Purpose social media, website, newsletters, promotional materials, and future event materials. I understand that my child may be photographed or videotaped.*

I understand that a parent, legal guardian, or caregiver authorized by the parent or legal guardian must remain on-site with the participant for the entire event.*

I understand that Saturday Breakfast Club is a community friendship and inclusion event and is not a respite care, childcare, medical, or therapeutic program.*

I understand that Samantha's Purpose, No Limits Coffee Shop, and their community volunteers cannot provide medical care, medication administration, behavioral support, one-on-one supervision, transportation, toileting assistance, feeding assistance, or other personal care services.*

I understand that the parent, legal guardian, or authorized caregiver attending with the participant remains responsible for the participant's supervision, safety, behavior, medical needs, personal care, and well-being throughout the event.*

I give permission for the participant to attend Saturday Breakfast Club.*

I have read and agree to the Event Waiver and Release of Liability.*