Youth Photography Summer Camp Registration

Youth Photography Summer Camp Registration

Please fill out your details to enroll in the class. Space is limited. Class sponsored by WI Black Historical Society Museum and Neighborhood Dispatch with Milwaukee Journal Sentinel.
Participant's Full Name

First NameLast Name
Name of School
Participant's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent or Guardian Name

First NameLast Name
Parent or Guardian Email
example@example.com
Parent or Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does your child own their own camera?
Tell us about your child's interest or experience in photography (optional)

Wisconsin Black Historical Society Museum
Neighborhood Dispatch / Milwaukee Journal Sentinel
Youth Photography Class Participation Waiver & Release Form

Program Description
The Youth Photography Class is a hands-on educational program sponsored by the Wisconsin Black Historical Society Museum and Neighborhood Dispatch (Milwaukee Journal Sentinel). Participants will learn photography fundamentals, lighting, composition, and exhibit preparation while taking photographs within the surrounding community.

Liability Waiver and Release
I, the undersigned parent/legal guardian of the above-named participant, understand and acknowledge that participation in the Youth Photography Class may involve walking tours, outdoor activities, use of photography equipment, and participation in community-based learning experiences.

I voluntarily allow my child to participate in this program and assume all risks associated with participation, including but not limited to minor injuries, accidents, transportation-related incidents, or loss/damage to personal property.

I hereby release, waive, and hold harmless the Wisconsin Black Historical Society Museum, Neighborhood Dispatch (Milwaukee Journal Sentinel), their employees, volunteers, sponsors, partners, and representatives from any and all liability, claims, demands, actions, or causes of action arising out of or related to participation in this program.

Medical Authorization
In the event of an emergency, I authorize program staff to seek emergency medical treatment for my child if I cannot be reached immediately.
Please list any allergies, medical conditions, or special needs:
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Assumption of Risk & Release of Liability
I understand that participation in photography classes and related activities may involve certain risks, including but not limited to travel, walking tours, use of photography equipment, and participation in group activities.

I voluntarily assume all risks associated with my child’s participation in the Youth Photography Class. I hereby release, waive, and discharge the Wisconsin Black Historical Society Museum, Neighborhood Dispatch, Milwaukee Journal Sentinel, their directors, officers, employees, volunteers, instructors, sponsors, and affiliates from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or illness that may occur during participation in the program.

Photo & Media Release
I grant permission for my child to be photographed, videotaped, or recorded during program activities. I understand that these images or recordings may be used for educational, promotional, marketing, archival, newspaper, social media, website, or publication purposes by the Wisconsin Black Historical Society Museum, Neighborhood Dispatch, and Milwaukee Journal Sentinel without compensation.
Equipment Responsibility
I understand that students may be provided with photography equipment and materials during the class. I agree that my child will use all equipment responsibly and return borrowed items in good condition, excluding normal wear and tear.

Code of Conduct
I understand that respectful behavior is expected at all times. Disruptive, unsafe, or inappropriate conduct may result in dismissal from the program.

Consent & Signature
I have read and fully understand this Participation Waiver & Release Form. By signing below, I acknowledge that I voluntarily agree to its terms and conditions.
Name

First NameLast Name
Signature
Should be Empty: