RELEASE OF LIABILITY FOR MINOR PARTICIPANTS: In Consideration of my minor child, being allowed to participate in any way in MoezArt Productions, Inc. programs, related events, classes and activities, the undersigned acknowledges, appreciates and agrees that: The risk of injury to my child from the activities involved in these programs is a possibility, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of injury does exist; and for myself, spouse, and child, I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my child’s participation; and I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from participation and bring such to the attention of the nearest official immediately; and I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives, and next of kin, hereby release MoezArt Productions, Inc. and any of its rented facilities, its officers, officials, board members, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers and if applicable, owners and leasers of premises’ used to conduct the events and classes, with respect to any and all injury, disability, death, or loss or damage to person or property incident to my child’s involvement in these programs whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law; and I, for myself, my spouse, my child and on behalf of my/our heirs, assigns, personal representatives, and next of kin, hereby indemnify and hold harmless all of the above releasees from any and all liabilities incident to my involvement or participation in these programs or classes to the fullest extent permitted by law. I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up these rights by signing it, and sign it freely and voluntarily without any inducement. Understanding of Risk: I understand the risks involved in participating in this program, by personal responsibilities for adhering to rules and regulations, and accept them as a participant. I understand and agree that if I am registering multiple students these terms apply to each student I am registering for this semester.
MEDICAL RELEASE: I give permission for any and all medical attention to be administered to my child, as a participant of MoezArt Productions, Inc. In the event of accident, injury, sickness, etc., I give my permission to MoezArt Productions staff to initiate any and/or all medical treatment until I can be contacted. In case I cannot be reached, the staff members of MoezArt Productions, Inc. are designated to act on my behalf. I also assume the responsibility for the payment of any such treatment. CONSENT FOR MEDICAL TREATMENT (MINOR): As the parent or legal guardian of the above named child, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. I understand and agree that if I am registering multiple students these terms apply to each student I am registering for this semester.
Is your child taking any medications? If yes, please list them below with your child's name:
Does your child have drug allergies or asthma? If yes, please explain. If registering multiple students please include your child's name below.
Are there any health problems/limitations or special needs: emotional, physical, learning, ext. that we need to be aware of? If yes, please list below with your child's name:
COMMUNICATION RELEASE - By signing this agreement, I give MoezArt Productions, Inc. permission to put my e-mail address on their Constant Contacts e-mail list and use my contact information to contact me regarding information for this activity and other MoezArt events and news.
PHOTOGRAPHY MODEL AND ZOOM RECORDING RELEASE: By signing this agreement, I give MoezArt Productions, Inc. permission in perpetuity to use my child's or children's images and words for this show and to publicize the work and productions of MoezArt Productions, Inc. I give permission for the MoezArt instructor to record the Zoom class for archival, training and quality purposes.