World Upside Down Arts Studio After School Showcase

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This waiver must be signed by all parents whose minor children are participating in one free day of after school programming and our After School Showcase.

Email *

Guardian's Full Name *

Guardian's Phone Number
*

Student Name *

Child or children participating in one day of free after school at World Upside Down Arts Studio.

Student Grade *

Student's School *

Waiver Release Form *

PARTICIPATION

I understand that World Upside Down Arts Studio is making its facility available for my child to participate in one day of After School Programming during the specified time.

WAIVER AND RELEASE

I hereby voluntarily, fully and forever waive, release and discharge World Upside Down Arts Studio, its owners, officers, directors, agents, employees, volunteers, and all other persons or entities acting in any capacity on its behalf (hereinafter referred to collectively as “WUDAS”) from any and all losses, liabilities, claims, expenses, demands, actions, damages, injuries, causes of action, and rights of action which are related to, arise out of, or are in any way connected with my child’s participation in activities at, with, or sponsored or administered by WUDAS. The foregoing waiver of liability includes, without limitation, damages or injury resulting from the negligence of WUDAS (whether such claims are based upon breach of contract, breach of warranty, or any other legal theory) or from any other cause or causes.

ASSUMPTION OF RISK

I understand that my child may suffer physical harm as a result of the acts or omissions of me, WUDAS, or other participants due to his or her participation in activities at, with, or sponsored or administered by WUDAS. My child elects to participate in spite of the risks.

COVENANT NOT TO SUE

I agree not to institute any suit or action at law or otherwise against WUDAS, or to initiate or assist in the prosecution of any claim for damages or cause of action which my child or I may have by reason of injury to my child, myself, or property related to, arising out of, or in any way connected with my child’s participation in activities at, with, or sponsored or administered by WUDAS.

INDEMNITY

I agree to indemnify, defend, and hold harmless WUDAS from any and all losses, liabilities, claims, expenses, actions or proceedings of any kind which may be initiated by myself, including on behalf of my child, or any other person or entity related to, arising out of, or in any way connected with my child’s participation in activities at, with, or sponsored or administered by WUDAS. This includes reimbursement for all legal costs and attorneys’ fees incurred by WUDAS, myself, and other indemnified parties, or any of them, for the defense of any such actions.

MEDICAL EXPENSES

I will pay for my child’s and my own emergency medical expenses and all subsequent medical expenses in the event of any incident, accident, illness or incapacity, regardless of whether I have otherwise authorized such expenses.

ATLANTOAXIAL INSTABILITY

If my child has Down Syndrome, he or she has had a neck x-ray and other medically recommended tests to screen for Atlantoaxial Instability, and has been cleared to participate in all activities at, with, or sponsored or administered by WUDAS, and I have delivered WUDAS a note from my child’s physician confirming the same. By signing this Waiver, I make all of the preceding statements for and on behalf of myself, my spouse, my children, my parents, and any of our or their heirs, assigns, personal representatives, and estates.

Yes. I, the guardian, agree to all of the above.

Required

Transportation *

I give permission for my child (“student”) to be transported in a motor vehicle driven by drivers hired by World Upside Down Arts Studio from the student's school to the arts studio according to the schedule agreed upon. I understand that my child is expected to follow all applicable laws regarding riding in a motor vehicle and

is expected to follow the directions provided by the driver and/or other adult volunteers.

I have read, understand, and discussed with my child that:
(1) They will be traveling in a motor vehicle driven by an adult and they are to wear their safety-belt while traveling;
(2) They are expected to respect each other, the vehicles they ride in, and the people they travel with during the trip;
(3) Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions or acts by riders, other drivers, or objects; and
(4) They are to remain in their seats and not be disruptive to the driver of the vehicle.

I recognize that by participating in this activity, as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses. As a condition for the transportation received, I, for myself, my child, my executors and assigns, further agree to release and forever discharge World Upside Down Arts Studio and their agents, officers, employees and volunteers from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation. I have read this entire waiver and permission form, fully understand it, and agree to be legally bound by its terms.

Yes. I, the guardian, agree to all of the above.

No. My student does not require transportation to this event.

Required

Photo Waiver
*

I, the undersigned, give permission for World Upside Down Arts Studio to use video footage and / or photographs of my child/ward. This usage may include (but is not exclusive to) displaying publicly, distributing, or publishing, photographs, and/or video of my child for use in materials that include, but may not be limited to: - printed materials (eg. - brochures and newsletters) - online and offline advertising and promotion - videos and digital images for use on Social Media. By signing this form, I acknowledge that I am giving unrestricted permission for my child's image to be used in print, video, and digital media. I agree that these images may be used by World Upside Down Arts Studio for a variety of purposes and that these images may be used without further notification. I do understand that any identifying information including surname and location will not be used in conjunction with any video or digital images.

Yes. I, the guardian, have read the above and agree.

No. I, the guardian, have read the above and disagree.

Required

Questions *

Do you have any questions about this event?

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