Arts by the River Registration Form
We're delighted to welcome you to our Arts by the River Programming, generously supported by the Medford Arts Council and Massachusetts Cultural Council.

The series mixes environmental and arts education starting with six weeks of nature dance in collaboration with Abilities Dance company in Medford, six Mondays from 3-4:15. April 7, 14, 21, May 5, May 12, May 19. Rain or Shine.
Please fill out the following registration and liability form to confirm your participation. We will follow up by email with location and more details.

Please note: KN95/KF94/N95 masks are required to be worn by all participants at all times during Mulberry Forest School events. We will have additional masks on hand.

Liability Waiver Arts by the River

I am aware, understand and agree that participating in any outdoor or indoor dance lesson or class, workshop, rehearsal or performance, outdoor, or environmental educational activity, or art workshop, there is a possibility of physical injury, risks, harm or loss. I acknowledge that I have considered and assumed such risks, including any and all risk of injury, harm, or loss (including costs associated with medical treatment) that may incur as a result of my child’s participation in programming.

I voluntarily agree, therefore, to assume all risks and responsibility for any such injury or accident, which might occur to me (or my child) during any of Mulberry Forest School, Access Culture Inc classes, lessons, rehearsals, performances, or activities.

Furthermore, I hereby waive, release, discharge, absolve, indemnify, and agree to hold harmless the Mulberry Forest School, their officers and employees, their Board of Directors, instructors, or assignees, Medford Parks and Recreation, Abilities Dance Company, and the  City of Medford from any liability and any claim arising out of injury or damages to you or your child resulting from participation in Mulberry Forest School programs (whether such injuries or damages were caused by the negligence of the Mulberry Forest School or otherwise).

I also exempt, release, and indemnify Mulberry Forest School, its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students from any and all liability claims, demands, or causes of action whatsoever from any damage, loss, injury, or death to me, my children, or property which may arise out of or in connection with participation in any classes or activities conducted by Mulberry Forest School. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold Mulberry Forest School its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students liable for such damage, loss, injury, or death.  I understand that I should be aware of my physical limitations and agree not to exceed them. If I am signing this waiver for my children, I certify that I am the parent or legal guardian and have the right to waive these rights. 
Abilities Dance Boston Media Release 

I hereby irrevocably consent to and authorize the use and reproduction by Abilities Dance Incorporated of any and all photographs, recordings, videotapes, and/or other reproductions of my likeness or characteristics (“reproductions”) for any purpose, whatsoever, without compensation. All reproductions shall constitute property of Abilities Dance Incorporated, solely and completely. I assign and release all rights to said reproductions and authorize Abilities Dance Incorporated, or others authorized by them, to exhibit, broadcast, and/or distribute or otherwise further reproduce said reproductions in whole or in part over in any medium whatsoever, including, without implied limitation, newsletters, radio, newspapers, closed circuit television, film, cable television, websites, and social media with or without compensation in perpetuity. I also release, discharge, and agree to hold harmless the producers or any persons, or entities acting under their permission or authority from any liability arising from the use of said reproduction.

Inclement Weather and Appropriate Attire

Weather. Inclement weather may affect programming without any prior notice. we reserve the right to cancel programming at our sole discretion. In most cases, this decision will be made and communicated to families via email and text message either the night before programming, or at least two hours before school begins.

Weather appropriate attire. Your child will be required to wear appropriate clothing for outdoor play, including, but not limited to, wool or thermal underlayers, rain pants, jackets and rain hats, and appropriate rain/snow boots.
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Parent/Guardian Full Name *
Email *
Name of First Child *
Age of First Child
Name Second Child
Age Second Child
Name Third Child
Age Third Child
Additional children Name and Age here
Emergency Contact Name *
Emergency Contact Phone Number *
What dance class days will you attend *
Required
My child will wear a KN95/KF94/N95 mask at all times during Mulberry Forest School activities *
Required
Does your child have any access needs?
I give permission for de-identified (no faces showing) pictures of my child to be used in Mulberry Forest School and Abilities Dance Company Promotional Materials.
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I understand and have read this entire waiver and agree to its contents. *
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