Flourishing Lives Release of Liability

This is a legally binding Consent Form and Release of Liability made voluntarily by me, the undersigned Releaser, on my own behalf and on behalf of my heirs, executors, administrators, legal representatives, and assigns to Flourishing Lives. By the execution of this waiver of liability form, I acknowledge that the child listed above is capable of participating in the activities. I also assume full responsibility for all risks of the child participating in the activities, whether such risks are known or unknown to me at this time. I release and hold harmless this organization, leaders, employees, contractors, volunteers, and any agents from any claim the child or I may have due to he result of any injury or illness incurred during participation in the Flourishing Lives activities. In an emergency, I acknowledge that I am solely responsible for all medical and other costs arising out of bodily injury or any loss sustained through participation in this activity. I authorize program/office/facility staff to secure any licensed hospital, physician, and/or medical personnel for any treatment deemed necessary for the participant’s immediate care.

Flourishing Lives Photo/Video Release 

I hereby grant Flourishing Lives the irrevocable right and permission to use photographs and/or video recordings of my child(ren) on their website and other websites and in publications, social media, promotional materials, educational materials, derivative works, or for any other similar purpose without compensation to me. I understand and agree that such photography and/or video recordings of my child(ren) may be placed on the internet. I also understand and agree that my child(ren) may be identified by name and/or in title in printed, internet, or broadcast information that might accompany the photographs and /or video recordings of them. I waive the right to approve the final product. I agree that all such portraits, pictures, photographs, video and audio recordings, and any reproductions thereof, and all plates, negatives, recording tape, and digital files are and shall remain the property of Flourishing Lives. I hereby release, acquit, and forever discharge Flourishing Lives, its current and former trustees, agents, officers, and employees of the above-named entities from any and all claims, demands, rights, promises, damages, and liabilities arising out of or in connection with the use or distribution of said photographs and/or video recordings, including but not limited to any claims for invasion of privacy, appropriation of likeness or defamation.

Financial Responsibility

Full payment must be received to reserve your child's spot in this group. There will be no refunds. 

By signing below, you certify that you are authorized to make decisions for the above-named child, that you agree to the liability releases as written, and that you agree to assume financial responsibility for services provided by Flourishing Lives.