Registration and Release Form for Sew with Sonia Summer Camp 2019
Email address *
Student Name *
Your answer
Student's Age *
Your answer
Which session would your child like to attend? *
Which week would your child like to attend? *
Required
Parent/Guardian Name *
Your answer
Address *
Your answer
Home Phone *
Your answer
Mobile Phone *
Your answer
Emergency Contact *
Name and phone number
Your answer
WAIVER OF LIABILITY, INDEMNITY AGREEMENT AND CERTIFICATION AND RELEASE FOR EMERGENCY MEDICAL TREATMENT
The undersigned (the “Participant”) and, if Participant is a minor, Participant’s parent or legal guardian, for and in consideration of the granting of permission by Sonia Moroder for Participant to engage in sewing classes (“Classes”):

1. Agrees not to sue and releases and discharges Sonia Moroder, together with her personal representatives, heirs, family, and next of kin (“Moroder”), from all liability to Participant, her personal representatives, heirs, and next of kin, for all loss or damage and waives any claim or demands an account of injury to or death of the Participant, or damage to the property of Participant, arising out of the participation of Participant in Classes. This agreement, release, waiver and discharge, shall not apply to any personal or property damage sustained by Participant arising from the negligent acts or omissions of Moroder.

2. Agrees to indemnify and hold harmless Moroder from any loss, liability, damage or costs that may be incurred due to the acts or omissions of Participant during participation in the above program.

3. The undersigned certify that the Participant is physically fit and able to engage in the Classes.

4. In the event of any accident (or sudden illness), Moroder has my permission to have performed whatever medical emergency treatment may be deemed necessary to Participant.

5. This Agreement shall be governed by the laws of the State of California.
Participant's Name *
Your answer
Date e-signed *
MM
/
DD
/
YYYY
Parent's or Legal Guardian's e-Signature *
By checking the "I agree to use electronic records and signatures" box below and selecting the "Submit" button, I confirm that: 1) I can access and read this Registration and Release Form for Sew with Sonia Summer Camp 2019; 2) I can print on paper this form and save it for future reference and access; 3) I have received, read, and understood the terms and conditions of this form; and 4) I consent to using electronic signatures.
Your answer
I agree to use electronic records and signatures *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service