Forge Youth Program Consent and Release Form
Please read this form carefully and go over with your child.
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Student Name *
Student birthdate: *
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DD
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YYYY
Class NAME and DATE registered for: *
Parent/Guardian *
Address *
Home Phone *
Mobile Phone *
Contact email address *
Emergency contact other than parent/guardian *
Emergency contact phone number *
Physician Name and phone number *
Insurance carrier and policy number *
ADMINISTRATION OF MEDICINE CONSENT: My child will need medication during the program hours and I request that he/she be assisted by designated personnel to follow the recommendations of our physician. I understand that the Forge accepts no responsibility for the administration of, or failure to administer, such medication at a specific time. I agree to hold The Forge and program instructors free from liability arising out of failure to administer any medication. *
Medication and method of administration (if yes above, or put NA) *
Does your child suffer from any medical conditions we should know about such as severe e.g. allergies to Bee stings, peanuts, other physical limitations etc. *
Photo Release: I grant permission for the use of photos of my child, and/or my child's artwork in printed or virtual materials designated for funding purposes, educational, news or promotional purposes related to The Forge *
The following person(s) are authorized to pick up my child from The Forge while attending summer camp. PLEASE INCLUDE THEIR PHONE NUMBER *
We strive to make our makerspace welcoming and accessible for all students, including those interested in metalworking, blacksmithing, woodworking, and glass arts. If your child has any disabilities, medical conditions, or other needs that we should be aware of to support their participation, could you please share this information with us? We are keen to discuss accommodations or adjustments that could help your child fully engage in our activities. How can we best support them? *
WAIVER AND RELEASE: We, the staff of The Curious Forge recognize our obligation to make sure students and their parents are aware of the risks and hazards associated with our programs. Students may suffer injuries, possibly minor, serious, or catastrophic in nature. All these movements can be dangerous and can lead to injury.Parents should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and the teachers’ instructions.The Forge and other staff members and representatives, whether paid or volunteer, will not accept responsibility for injuries sustained by any student during the course of, or while traveling to and from, our programs in which he or she may participate.In the event of an emergency, I grant permission for my child to receive medical treatment and to be hospitalized if deemed necessary. It is understood that every attempt will be made to contact me or the person named above before taking this action. I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage, which I consider adequate for my child(ren)’s protection.As a parent/guardian of a minor, I verify that the dangers of the activities and the significance of this Release and Waiver were explained to, and understood by the participant.I grant permission for my child to participate in the Curious Forge Youth Arts Program. I agree that I will not hold The Forges' board, staff, program instructors, or volunteers liable for any injuries sustained, illness contracted, or loss of property while my child is participating in, or traveling to and from any Youth Programming.    I CERTIFY THAT I HAVE CAREFULLY READ AND UNDERSTAND CONTENTS OF THIS DOCUMENT IN ITS ENTIRETY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN THE CENTER FOR THE ARTS AND THE LESSOR, AND MYSELF, AND SIGN IT OF MY OWN FREE WILL. (your full name and DATE needs to be typed in *
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