• Youth Creative Collective After-School Artistic Expression Workshop 2023

    Registration Form; Medical, Contact and Authorized Pick Up Information
  • PERSONAL INFO

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  • Authorized Pickup Person(s)

    Please list the names of those you authorize to pick up your child in the event you are not available to do so.
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  • Medical Information

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  • Information Release

    Please read the following and sign if you agree to ALL statements
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    LIABILITY RELEASE

     

    I give permission for my child to participate in Youth Creative Collective at The Dream Center. While most activities will be arts-based and indoors, one of the activities will include my child traveling, accompanied by the adult staff of Youth Creative Collective, to nearby playgrounds on warm, weather days and I give consent. I understand that participation in these activities requires participants to abide by applicable rules and standards of conduct. I hereby release The Dream Center staff and volunteers from responsibility and liability for any illness or injury that my child may sustain during this program. In the event of an emergency, I hereby authorize an adult leader of this program, as an agent for me, to consent to medical attention from a licensed medical professional. I expect to be contacted as soon as possible. I agree not to bring my child to any sessions of Youth Creative Collective if my child is ill. 

     

    MEDIA RELEASE

     

    I also give The Dream Center permission to publish in print, electronic or video format the likeness or image of my child and/or audio recording of my child. I release all claims against The Dream Center with respect to copyright ownership and publication including any claim for compensation related to the use of materials. Images, video or audio recordings of my child taken or recorded by The Dream Center can be used in print, broadcasting or other forms of marketing and advertising: brochures, newsletters, reports, online (website, Twitter, Facebook, Instagram, YouTube). These photos, videos or other images of recordings may be used by The Dream Center without payment of fees, royalties or other remuneration.

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