Official Liability & Assurances Form (Safety Form)

1
Student Name* This field is required.Please write the name of the actor/participant.
First Name
Last Name
2
Email* This field is required.Minors should input their parent or guardian's email.
example@example.com
3
Phone Number* This field is required.Minors should input their parent of guardian's phone number
Area Code
Phone Number
4
Known Food AllergiesPlease let us know of any allergies that could prevent a positive experience at our facility.
You may put "N/A" if applicable.
5
Emergency ContactPlease list any emergency name(s) and contact information you’d like for us to have on file in case any issue arises during training.
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Attention to Educational and Medical NeedsOur classes may involve breathing techniques, physical body movement, camera lighting, vocal exercises, script reading, public performances and reading comprehension. Use the below space to share any information you wish for the instructor to know in advance to support your training experience. *This information shall remain confidential between actor and the instructor and never shared publicly.
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Bathroom Expectations* This field is required.Studio bathrooms are located past the front lobby of Unit A & B. The location of a class or film set may not be immediately next to those bathrooms. Therefore, I give permission for in-STUDIO instructors to permit my child (myself) to walk to the bathroom independently and leave the class training space. I am aware that the class will not stop or pause its lesson plan during an independent bathroom break. Additionally, in-STUDIO instructors are not permitted to enter a bathroom while it is occupied, regardless of reason or actor request. All actors must be able to use the restroom independently.
YESNO
8
Release of Liability* This field is required.I am aware that actor training and the exercises associated with it place emotional demands on the body and mind. On behalf of my child and myself (and I am no longer a minor, on my behalf), I assume the risk and agree that in-STUDIO shall not be liable in any way for injuries sustained during attendance at the studio or any of its related functions. It is also understood that actor education may include physical contact from the instructor or fellow students as part of regular class work.
YESNO
9
Photo & Video Release* This field is required.The majority of classes at in-STUDIO are performed in front of a cinema camera. Instructors are encouraged to share those recordings with the actors as part of their training curriculum. I hereby grant in-STUDIO’s videographer and/or photographers the right and permission to press record, use, reuse, publish, and republish photographic pictures and videos of my child or myself, or reproductions thereof, in color or black and white for any purposes whatsoever, including the use of any printed matter in conjunction therewith. I hereby waive any right to inspect or approve the finished photograph, video, and/or advertising copy or printed matter that may be used in conjunction therewith or to the eventual use that it might be applied. I hereby release in-STUDIO from any liability as a result of any distortion, blurring, alteration, optical illusion, or use in composite form, whether intentionally or otherwise, that may occur or be produced in the finished product, its publication, or distribution. I have read the foregoing release, authorization, and agreement and warrant that I fully understand the contents thereof. in-STUDIO has no desire to post, share or promote an image or video of an actor that would highlight the facility or class curriculum in a negative way.
YESNO
10
Studio Handbook* This field is required.I understand that all actors are responsible for the written policies, expectations and contents found within the student handbook, regardless of whether they choose to read it. The handbook is located in the "More" section of our website.
YESNO
11
Arrival/Departure* This field is required.I understand that actors should not enter the training space more than 10 minutes before their official start time, as it may interfere with another class or studio recording. I also understand that instructors are not responsible for students more than 10 minutes after class has officially ended. A childcare fee may be assessed to the account of parents who fail to pick up their child within 10 minutes of the official wrap of class.
YESNO
12
Picking Up MinorsI agree to inform in-STUDIO staff of who will pick up minor aged children and ensure they are aware that an ID may be requested. in-STUDIO will not be held liable for any pick-up of a minor, if the parent or guardian fails to provide this information. It shall be assumed a parent or guardian of the child actor will always pick them up from our facilities.
YESNO
13
Third Party TransportationActors over the age of 18, as well as families who decide to allow their children under the age of 18 to use an alternate transportation plan (i.e. a city bus, taxi, Uber, Lyft, etc.) must agree to this by clicking YES. By doing so, they release, waive, discharge and covenant not to sue in-STUDIO, its corporate entity, its staff, or instructors (hereinafter referred to as releasees) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or relating to any loss, damage, or injury, including death, that may be sustained by my minor child(ren) or me, or any of the property belonging to me or them, as a result of, or in any way arising out of my child(ren) traveling to and/or from in-STUDIO or an in-STUDIO event. By clicking YES, you further agree to indemnify and hold harmless the releasees from any loss, liability, damage or costs arising in any way out of my child(ren) traveling to and/or from in-STUDIO or an in-STUDIO event using an alternate transportation plan. By clicking NO, you are stating you will never use third-party transportation while being a registered student at in-STUDIO.
YESNO
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Signature of CompletionI agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
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