Create with us today! | Art Studio (not just) For Children

Email Address *

Message if necessary

Name of Artist

First

Last

age of artist by start of camp/class

I am interested in/registering for *

registration form

fill this out for all camps and classes you have registered and paid for

start date of art program or camp

PARTICIPANT WAIVER | Art Studio For Children (ASFC) Art Camp   (RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT) In consideration of participating in ASFC Art Camp, I/my minor child or ward, (above named participant) represent(s) that I understand the active nature of camp. I fully understand that this type of event involves risks of injury and serious bodily injury, including permanent disability, paralysis and death, which may be caused by my minor child or ward’s own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the “releases” named below; and that there may be other risks either not known to me/my minor child or ward or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I/my minor child or ward may incur as a result of my/my minor child or ward’s participation in the event, except for losses, costs and damages that are the result of the gross negligence of others.   I hereby release, discharge, and covenant not to sue ASFC, Nancy Macdonald, their administrators, directors, agents, officers, volunteers, approved drivers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the event takes place or utilizes, from all liability, claims, demands, losses, or damages on my account, except for any liability, claims, demands, losses, or damages caused by gross negligence.  I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I/my Parent/Legal Guardian have/has given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that, if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.

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Advertising and Promotion   ASFC and Nancy Macdonald, have my permission, (both during and any time after), to use my (or my minor child/ward’s) likeness, voice or words in either television, radio, film, newspapers, magazines, and other media, and in any form, for the purpose of advertising or communicating the purposes and activities of ASFC, and/or applying for funds to support these purposes and activities, I further waive any current or future right to seek compensation for said use.    

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Name

First

Last

Emergency Phone & Contact

OHIP #

Last Tetanus

Doctor's Name and Number

List any chronic disability/illness/allergy and measures required

Any physical/social/medical/emotional conditions that may prevent artist from participating in any aspect of our programme

List any medication your child is currently taking

In the event that I cannot be reached in an emergency, I hereby give permission to the physician in attendance to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child/ward as named below

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