Informed Consent/Acknowledgment/Medical Release and Authorization
By participating, I hereby give my approval in any and all activities prepared by STAR Repertory Theatre during the show. In exchange for the acceptance of said candidacy by STAR Repertory Theatre, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless STAR Repertory Theatre and all its respective officers, agents, and representatives from any and all liability for injuries arising out of traveling to, participating in, or returning from selected rehearsal/show sessions.
In case of injury, I hereby waive all claims against STAR Repertory Theatre including all directors and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the show. There is a risk of being injured that is inherent in all activities.
By signing below, you agree to indemnify STAR Repertory Theatre and all of their officers, their families, agents, employees, production staff, performance venues, subcontractors, independent contractors and hold them free and harmless to any property damage, bodily injury or death or any other element of damage of any kind occurring anytime you or your child is engaged in an activity or on behalf of, or related to STAR Repertory Theatre.
As Parent and/or Guardian or participant, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of myself or a minor child, 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 myself or a minor child. 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 STAR Repertory Theatre, and its affiliates including Directors, Assistant Directors, Choreographers, Musical Directors, and Volunteer Parents to provide the needed emergency treatment prior to myself or the minor child’s admission to the medical facility.
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 myself or the named minor child, in my absence.