Student Name * First Name Last Name Parent/Guardian Name First Name Last Name Time * Hour Minute Second AM PM Email Phone (###) ### #### Liability Waiver * I/We, the undersigned, are either a student or the parent(s)/guardian(s) of the above-named student(s) and I/we agree, in taking advantage of the 2024 Summer Art Camp provided by The Goddard Center for the Visual and Performing Arts (“GC”), to release and hold harmless GC, its directors, offices, employees and consultants from any and all claims, demands, suits, costs and charges in connection with or arising out of provision of the 2024 Summer Art Camp, including, but not limited to, bodily harm or injury to the student(s), except only for loss, harm or injury occasioned by gross negligence or intentional misconduct by GC. We/I hereby grant permission for GC and its personnel full authority to take whatever actions they deem necessary regarding the students’ health and safety in the event I/we cannot be reached or in the situation where time is of the essence; and fully release GC and its personnel from any liability in connection with those decisions. I/we acknowledge that GC is implementing protocols and procedures to ensure the safety of the student(s). I/we acknowledge that GC will take any action in the best interest of the student(s) and GC will report any disturbance to me/us as soon as possible. I have read and agree to this waiver. Photo Release * I grant to The Charles B. Goddard Center for the Visual and Performing Arts, its representatives and employees the right to take photographs of my child/grandchild in connection with the above-identified subject. I authorize The Goddard Center, its assigns and transferees to use and publish the same in print and/or electronically. *The Goddard Center further agrees to limit the lawful use of such photographers for publicity in local papers, on Facebook for promoting arts programing and on the Goddard Center's website. I have read and agree to this waiver. SIGNATURE * Thank you!
