Liability Waiver & Photo Release

LIABILITY WAIVER AND PHOTO RELEASE

Student/Member Name

First Name

Last Name

Please select one

I certify that I am 18 years or older and will complete this waiver for myself

If Student/Member is under 18 years old, I certify that I am the Parent/Guardian and will complete this waiver on their behalf

Liability Waiver

I/we realize that participation in industrial arts classes and activities could involve possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the student and/or parent/guardian) assume all risks related to the use of any and all spaces used by Chicago Industrial Arts and Design Center, NFP (hereinafter “CIADC”).

I/we agree to release and hold harmless CIADC, including its board, instructors, staff members, and facilities from any cause of action, claims, or demands now and in the future. I/we will not hold CIADC liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes or from use of the premises. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by CIADC.

In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes or use of the facilities, I/we agree to report the unsafe conduct or conditions to the CIADC Executive Director, CIADC instructor or CIADC staff member as soon as possible.

Acknowledgement

I have read the above content and agree to the terms of the Liability Waiver.

Photo Release

I/we on my/our own behalf and on behalf of my/our minor child I hereby authorize CIADC to use pictures, video and recordings of myself or my/our minor child either provided by me/us or taken by CIADC or its agents to further the promotion purposes of CIADC.

I/we on my/our own behalf and on behalf of my/our minor child fully and forever release and discharge CIADC of and from any and all claims, demands, actions, causes of action, suits, controversies and liabilities of any kind and nature accruing to me or to them and arising directly or indirectly from the use of names, photographs, pictures, video or recordings. Photographs, pictures, video or recordings are to be used exclusively by CIADC and may not be sold, licensed or otherwise transferred directly by CIADC

Acknowledgement

I have read the above content and agree to the terms of the Photo Release.

Please indicate a contact person in case of emergency. If possible, please choose someone who will not be in the same Class or working in the same Shop as the Student/Member.

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Relationship to Student/Member

Electronic Signature of Student/Member -or- Parent/Guardian if Student/Member is under the age of 18

Your typed name acts as your electronic signature

Today's Date

YYYY

LIABILITY WAIVER AND PHOTO RELEASE

6433 N. RAVENSWOOD CHICAGO, IL 60626

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