Emergency Contact / Liability Waiver Form
All individuals enrolled in Art Seed Programs must fill out the following form. Please complete by Thursday June 24th, 2025. No need to print and send, it will automatically record your response.
Email *
Weeks Attending Camp *
Required
Name of Child (or Children) Attending
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Emergency Contact Name
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Emergency contact's Relationship to Child
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Emergency Contact Phone Number
 *
Please list anything you'd like us to know, examples are any allergies, medical conditions, or medications your child will need to take. 
Assumption of Risk: I understand that participation in the Art Seed Studio Summer Program involves various activities that may include, but are not limited to, pottery, painting, sewing, drawing, and games. I acknowledge that these activities carry inherent risks, including but not limited to: 

1-Minor injuries such as cuts, bruises, and scrapes 
2-Potential allergic reactions to art materials
3-Possible damage to clothing or personal items. 
4- More serious injuries in rare cases

I voluntarily assume all risks associated with my child's participation in these activities.

Release and Waiver: I hereby release, waive, and discharge Art Seed Studio, LLC, its officers, employees, agents, and volunteers from any and all liability, claims, demands, actions, and causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained by my child while participating in the program or while on the premises, regardless of whether such loss is caused by the negligence of the released parties.

 Medical Considerations and Release:   I understand that Art Seed Studio, LLC does not provide medical insurance for participants. In the event of a medical emergency, I authorize the staff of Art Seed Studio, LLC to seek medical treatment for my child. I agree to bear any costs associated with such treatment. I authorize the staff of Art Seed Studio Summer Program to share relevant medical information about my child with emergency medical personnel in the event of an injury or medical emergency. 

Personal Property: I acknowledge that Art Seed Studio, LLC is not responsible for lost, stolen, or damaged personal property.

Behavior Expectations: I understand that my child is expected to follow all rules and instructions provided by the program staff. Art Seed Studio, LLC reserves the right to dismiss any participant whose behavior is disruptive or compromises the safety of themselves or others, without refund.

 Infectious Diseases: I understand that participation in this program may expose my child to the risk of infectious diseases, including but not limited to COVID-19. I assume this risk and agree to hold Art Seed Studio, LLC harmless in the event of such exposure or illness.

Indemnification:  I agree to indemnify and hold harmless Art Seed Studio, LLC from any claims, damages, losses, or expenses arising from my child's participation in the program.

Acknowledgment of Policies:  I acknowledge that I have read and agree to the terms and conditions outlined in the Art Seed Studio Summer Program policies, including the cancellation policy and any other relevant guidelines.

Severability:  If any portion of this waiver is found to be void or unenforceable, the remaining portions shall remain in full force and effect.


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Required
Parent/Guardian Electronic Signature: By typing my full name below, I understand and agree that this constitutes a legal signature confirming that I acknowledge and agree to all the statements and terms outlined in this form.
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Date
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Final Confirmation: I confirm that all information provided in this form is accurate and complete to the best of my knowledge.
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Required
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