Informed Consent and Acknowledgement
By signing this registration form, I hereby give my approval for my child’s participation in any and all activities prepared by Glow & Grow Inc during the Grow & Glow Garden Club. In exchange for the acceptance of said child’s candidacy by Glow & Grow Inc, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Glow & Grow Inc and all its respective officers, agents, and representatives, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, volunteers, and, if applicable, owners and lessors of premises used to conduct the club, from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.
In case of injury to said child, I (and on behalf of my child) waive all claims against and forever release, discharge, and agree to hold harmless and indemnify Glow & Grow Inc and all its respective officers, agents, and representatives, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, volunteers, and, if applicable, owners and lessors of premises used to conduct the club from and against all loss, liability, claims, or harm occurring on, in, or on the premises rented, leased, or utilized by Glow & Grow for the club, or in any way arising out of (a) attendance at or participation in the Activity and/or (b) use of any facility, service, or equipment provided by Glow & Grow Inc.
Photo, Video, & Feedback Consent and Acknowledgement
By signing this registration form, I grant permission to Glow & Grow Inc, its agents, its employees, & contracted staff irrevocable and unrestricted rights to my image, written feedback, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration for any lawful purpose, including publication, promotion, archive in any manner or any medium that exists now or in the future.
Medical Release and Authorization
By signing this registration form, as Parent, Caregiver, and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the 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 the named athlete. 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 Glow & Grow Inc and its affiliates including directors, teachers, and assistants 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 season.
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.