CONSENT
Media and Social Media release
I (parent/caregiver) hereby consent to the Kiilalaana Program and its Partners to take or have taken by others, photographs, digital images and/or audio and/or video footage (the images) of the young person named below, and to store the images, make copies of the images and publish the images in any form, in whole or
in part, and distribute them in any medium including, but not limited to, print media, the Internet, Social Media, other multi-media uses or graphic representation, cinematography or video.
I consent to the images being used by the Kiilalaana or provided to others for the following purposes only:
• General news or promotion of the event on TV, Radio or in Newspapers, in trade and other journals and
on websites and the internet.
• The production of resources/programs that will assist development and growth of the Kiilalana mission,
• Promoting and advertising the resulting educational products/resources,
Kiilalaana and its Partners undertake not to use any images in a way that would cause embarrassment or misrepresent the intent of the student’s participation.
I understand that neither I nor the student will be paid for giving this permission and I hereby waive any claim that I or we may have or may have had for remuneration, residuals, royalties or any other payment in respect of use of the images.
I agree that Kiilalaana and its Partners shall not be bound to make any use of the images.
Medical Release and Authorization
As Parent and/or Guardian of the named young person, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the young person, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named young person. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Kiilalaana. And its affiliates including Staff, Facilitators, Volunteers and Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered events. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Informed Consent and Acknowledgement
I hereby give my approval for my child’s participation in any and all activities prepared by Kiilalaana during their registration for the year of 2023 In exchange for the acceptance of said young person's participation in the Kiilalaana Tidda's Program. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Kiilalaana. And all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected sessions. In case of injury to said child, I hereby waive all claims against Kiilalaana. Including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities, and events. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.