In case of Emergency contact (other than parents):Option AName: First Name* Last Name* Phone: Area Code* Phone Number*
Option BName: First Name Last Name Phone: Area Code Phone Number
Activity restrictions (mark with x): Yes No If Yes, please explain: Does your child(ren) have health insurance? (mark with x)Yes blanks No blankName Of Insurance Provider Phone number Area Code Phone Number Policy Number Child A Policy Number Child B Policy Number Child C
Waiver and Release of Liability:I, the undersigned, as the parent/guardian of the above-named child, hereby grant permission for my child to participate in the Ciclo SF Day Camp located at 345 Judah Street, San Francisco, California. I understand that participation in camp activities may involve risks, including, but not limited to, physical injury, and I assume all risks associated with participation in camp activities.I hereby release, discharge, and hold harmless Ciclo SF, its staff, volunteers, and affiliates from any and all claims, liabilities, or damages arising from my child's participation in camp activities. This waiver and release include, but are not limited to, any claims or causes of action for personal injury, property damage, or wrongful death, whether caused by negligence or otherwise.Medical Treatment Authorization:In the event of an emergency, I authorize [Camp Name] and its representatives to obtain medical treatment for my child as deemed necessary. I understand that I will be responsible for any medical expenses incurred as a result of such treatment.Photograph and Video Release:I grant permission for Ciclo Sewing Lab to take photographs and videos of my child during camp activities. I understand that these images may be used for promotional purposes, including but not limited to, social media, websites, and printed materials. I waive any right to royalties or other compensation arising from or related to the use of these images.Code of Conduct:I acknowledge that my child is expected to adhere to the camp’s code of conduct and follow all rules and guidelines set forth by the camp staff. I understand that failure to comply with these rules may result in my child’s dismissal from the camp without a refund.Acknowledgment of Understanding:I have read this waiver and release of liability and fully understand its terms. I acknowledge that I am signing this agreement freely and voluntarily, and I intend by my signature to grant a complete and unconditional release of all liability to the greatest extent allowed by law.