Please read the following and sign at the bottom:
I, the undersigned parent or legal guardian of the above named child, do hereby give my permission for the child named above to participate in the activities identified above planned by The School of Arts. I am aware of and consent to the scope of the activity to be engaged in and mode of transportation being employed. I understand that participation in The School of Arts program activities requires an acceptance of risk. I am aware of and accept the risks associated with the activity to be engaged in and the mode of transportation being used.
I certify that the indicated participant(s) is/are in good physical and mental health and has/have never been declared medically ineligible for physical activity. I understand that participation in The School of Arts program activities requires an acceptance of risk. With my signature, on behalf of myself and the above named child I hereby waive, release and hold harmless the sponsors, promoter and all other persons and entities associated with The School of Arts programs and events from any and all claims, demands, actions, causes of action, obligations, debts, damages, losses, liens, liabilities, costs, attorneys fees, debts and expenses of every kind and nature whatsoever, in law or in equity, known or unknown, fixed or contingent, including any and all rights to subrogation therefore which arise out of, result from or are related to the above-named child's participation in the activities set forth herein.
If I cannot be reached in case of an emergency, I hereby authorize The School of Arts or its affiliates to contact 911 or a medical facility or physician of their choice to provide proper treatment and that I will be responsible for all expenses arising out of or related to such treatment. I hereby authorize and consent to any x-ray examination, anesthetic, medical and/or surgical diagnosis or treatment and hospital care which is deemed necessary and is rendered under the general or special supervision of any licensed physician or surgeon or the medical staff of an emergency medical service provider or a licensed hospital, whether such examination, diagnosis, or treatment is rendered at the office of the physician or surgeon or at the hospital. I understand that this medical authorization and consent is given (1) in advance of any specific examination, diagnosis, treatment, or hospital care being required and (2) to authorize The School of Arts staff to consent to examinations, diagnosis, treatment, or hospital care which is deemed advisable by a licensed physician or surgeon or the medical staff of an emergency medical service provider or a licensed hospital. This authorization shall remain effective until revoked in writing.
Furthermore, I hereby grant full permission to use the above participant(s) photograph in video tapes, publications, motion pictures, recordings, or other records of events. I have read and fully understand the foregoing and certify and represent that, as parent/guardian for the above child(ren), all registration and release information provided is true. I hereby represent that I have authority to bind and sign on behalf of all parent/guardians of the above participant(s).