Summer Break Arts Camp - Hartford Middle School Band Room - July 18 thru 22
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Email *
Participant's First and Last Name. *
Participant's address: Street, Town, State, Zip *
Where will participant attend school in Fall 2022: *
Indicate the grade participant is entering in Fall 2022: *
List forms of Art you enjoy creating or observing: *
Parent/Guardian full name(s) *
Parent/Guardian email address *
Parent/Guardian Phone *
As part of our Summer Break Arts Camp, we may take photographs and videos of participants in action. This media could be used for promotion of the program or agency. Any use of these images will NOT include names and/or other personal information of the participants. Do you consent to Second Growth using your child’s photograph and/or video image for the purposes mentioned? *
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from Second Growth's Summer Break Arts Camp. (B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned here from any and all liabilities or claims made as a result of participation in Summer Break Arts Camp, whether caused by negligence or otherwise.The accident waiver & release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. By agreeing to these terms, I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL. *
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COVID-19 PROTOCOL DISCLOSURE, WAIVER AND RELEASE OF LIABILITY.                                                           In addition to the above Waiver and Release of Liability, Second Growth is disclosing that we will adhere to any protocols that are in place at the time Summer Break Arts Camp is held. Prior to the first day of Arts Camp, Second Growth will inform parents, guardians, and participants about protocols that may be in place.  I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL. *
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