Convention Youth Permission Form – ADGA Annual Convention

The Youth Permission Form is required for ALL Youth (under age 21). Please have this form filled out before checking in for the Convention. If the youth is under 18, it must be filled out by a parent or guardian.

Name of Convention Registrant*

Address*

City*

State*

Phone*

Email*

Age of Participant*

Parent’s Name*

Phone Number*

Emergency Contact #1 Name*

Emergency Contact #1 Phone No.*

Relationship to Youth*

Emergency Contact #2 Name*

Emergency Contact #2 Phone No.*

Relationship to Youth*

Health Insurance Provider & Number*

As a parent, are you attending the 2025 ADGA Convention

Yes

If no is selected above, please provide the name and phone number of an adult attending the Convention who is chaperoning your child

If your child requires any learning of physical accommodations, please explain what is needed so we may be prepared to assist them during the youth program activities:

Please list any activity restrictions, diet restrictions, drug allergies, or medical conditions:

By clicking submit, I hereby permit my son or daughter to participate in the 2025 ADGA Annual Convention at the DoubleTree by Hilton Boston North Shore during October 18-19, 2025. I also agree that their name and picture can be used by ADGA for promotional purposes. I am aware of the planned activities and do hereby assume all risks and will hold the American Dairy Goat Association (ADGA), the ADGA Host Committee, the DoubleTree by Hilton Boston North Shore, and adult supervisors harmless from any and all liability, actions, causes of actions, debts, claims and demands of every kind and nature whatsoever, which I now have or which may arise from or in connection with the 2025 ADGA Annual Convention. The terms hereof shall serve as a release and assumption of risk for my heirs, executors, administrators, and for all members of my family. The 2025 ADGA Annual Convention Host Group has my permission to seek medical attention for the above-named, if needed. I have advised my child that they are expected to behave responsibly both onsite and offsite during the entire time they are in attendance at the Convention.