Brooklyn Sewcial Inc

                                                                        

Brooklyn Sewcial offers a nurturing and safe environment where students can be creative and have fun. We encourage our students to explore and experience the process of sewing, pottery and modern crafting.

                                                

Waiver and Release of All Claims and Assumption of Risk

                                                

Please read carefully before signing.

                                                

In consideration of being allowed to participate in any way in the program, related events and activities, and use of equipment, I, on my own behalf and on behalf of those minor children listed below, acknowledge, understand and agree:

                                                

1. That there is a risk of injury, including significant injury, from the activities involved in this program. I FREELY ASSUME ALL SUCH RISKS, both known and unknown, and assume full responsibility for my participation.

                                                

2. To comply with terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.

                                                

3. To HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS NOBLE TILE & VESSEL INC, including all of its owners, employees, representatives, agents, suppliers, vendors and other participants or guests, and the owners and lessors of the premises used to conduct the program (collectively, the “RELEASEES”), from any and all claims, demands, damages, losses and liability arising out of or related to any INJURY, DISABILITY OR DEATH I may suffer, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

                                                

Participant Name Printed ________________________________________________________________________________

                                                

Parent/Guardian Name Printed __________________________________________________________________________

                                                

Parent/Guardian Signature _________________________________________Date ________________________________

87 19th Street, Brooklyn, NY, 11232   |   http://www.brooklynsewcial.com/

Alexa: 516.512.2805    |    E-Mail: BrooklynSewcial@gmail.com

Student Registration

                                                                        

Brooklyn Sewcial offers a nurturing and safe environment where students can be creative and have fun. We encourage our students to explore and experience the process of sewing, pottery and modern crafting.

Student name:_____________________________________  Age:_____________  Birthday: _________________________

Parents name: ____________________________________ Home Number:_______________________________________

Cell Number:_____________________________________   Email:_________________________________________________

Week of Interest: __________________________________ Second Choice: ______________________________________

Emergency Contact: _______________________________ Relationship to student:_____________________________

Phone:_______________________________________________

Other Pick-up:_______________________________________ Phone:______________________________________________

Pediatrician Name: __________________________________ Phone: _____________________________________________

Allergies: __________________________________________________________________________________________________

Special Notes: _____________________________________________________________________________________________

Any Special Requests (projects, or other): ________________________________________________________________

_____________________________________________________________________________________________________________

Do you consent to photos being taken of your child during class: Yes_____ No______

Do you consent to use of these photos being used on social media, and for promotional use? Yes___No___                                                                                                            Initial ___________________ X

Name of Guardian ______________________________________ Date _______________________________

Signature of Guardian ________________________________________________

                     

87 19th Street, Brooklyn, NY, 11232   |   http://www.brooklynsewcial.com/

Alexa: 516.512.2805    |    E-Mail: BrooklynSewcial@gmail.com