The undersigned, the parent or legal guardian of _____________________________________, a minor, grants permission for the minor to participate in Children’s Community Theatre’s (CCT) Imagination Camp 2014 and other activities provided or sponsored by CCT. I understand that and acknowledge that I am responsible for all costs for medical treatment that may result from injury or sickness, or other damages that otherwise result, relate to or arise from participation in CCT activities. I request that CCT allow the named child to participate in CCT activities, in consideration thereof, agrees to release and forever discharge CCT, its officers and directors, their self-contracted employees, agents and parties volunteering on behalf of CCT from all actions, causes of action or claims for damage of any kind relation to any CCT activities in which the undersigned or the above mentioned child participates. I acknowledge that this is a full and complete release of all inquiries, sicknesses, and damages that may be sustained or incurred as a result of participation in CCT activities. I give permission to any CCT personnel (afore mentioned) to contact Emergency Services on behalf of the undersigned if the undersigned in unavailable for consultation in an emergency situation. I give permission to CCT to use any photographs or pictures, videotapes, website and/or sound recordings during CCT activities which may include my child, in promotional materials.


Parent/Guardian Signature: _______________________________________ Date: