‘Shells & Play’ Signup Form
This special event is located at AYO: 11714 sw 132nd Court Miami, Florida 33186 (Please fill out separate registration forms for more than one child)
Child's Name
*
First Name
Last Name
Legal Guardian Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does Your Child Attend a Round Robin Playgroup? If so, which one?
Waivers & Releases
Media Release: I hereby grant permission, without reservation, to the Round Robin Playgroup (“RRP”), and those authorized by RRP, to take photographs and to make recordings of myself and my child, and to use them in original or modified form in all media now or hereafter known, with or without my child’s name or information about him/her, for the promotion, public education, and/or fundraising activities of the organization. I hold harmless and release and forever discharge RRP their officers, directors, agents, employees, independent contractors, affiliated agencies, licensees, and assignees from all claims, demands, and causes of action that I, my children, our heirs, representatives, executors, administrators, or other persons acting on behalf of my or my child(ren)’s estate, have now or in the future may have, relating to the above. I also agree that RRP will be the sole owner of all tangible and intangible rights in the above-mentioned photographs and recordings, with full power of disposition. [please see Terms & Conditions for further details]
*
I have read the above and fully understand this release and its contents, and I consent on behalf of myself and my child(ren), a minor under the age of 18.
Payment
*
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USD
$25 SD
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