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Barrow Group Participant Release Form
By completing this form, I am agreeing to the following:
On behalf of the student of whom I am parent/guardian, I agree to indemnify and hold harmless, Barrow Group Inc., its executive officers, Board of Trustees, agents, employees, faculty and associates from any and all losses, damage suits, claims, costs, medical or other related expenses, demands, judgments or liabilities, whatsoever, arising out of, or in any way connected with, the Barrow Group Acting Class, particularly regarding any physical injury incurred as a result of the participation in the program, or as a result of the above named program, and from any resulting medical expenses. Further more, I grant permission for him/her to be included in any audio/video tape and/or photographs made of his/her participation in the above mentioned program, and further grant The Barrow Group permission to use such video/audio tape and/or photos for any education research or promotion of Barrow Group programs. *
Parent/Legal Guardian Name *
Student Name *
Date *
Barrow Group Representative Name
Date
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