Big Picture Foundation Release Form
* Big Picture Foundation activities happen at a wide range of Rye venues. Rather than asking parents to fill out weekly release forms, our comprehensive form covers many of our programs.


I, the undersigned, certify that I am either the Big Picture Foundation Inc ("BPF") participant who has attained the age of 18 years, or I am the parent or legal guardian of the child-participant and hereby give my consent for the child-participant to attend events organized by BPF, its successors, officers, members, directors, volunteers, employees, donors, and agents (the "BPF Parties"). I give the child-participant permission to travel independently or with the BPF Parties to and from such events, which I understand may take place in a variety of locations, including, but not limited to the following:

• Local BPF Parties' houses
• Local Rye, New York businesses
• The Rye Arts Center
• Damiano Recreation Center/Recreation Park (the Rye Rec)
• Other town sports and recreation areas
• Rye City Hall
• The Rye Library
• The Rye Schools
• Rye spiritual centers (for secular BPF activities)
• Other local venues

I give my child- participant permission to travel independently or with BPF Parties to and from BPF events, which I understand may also take place at locations outside of the child-participant's state of residence. Additional permission slips will not be required if attendance is optional, in which case, parents are required to make arrangements for transportation. When BPF officers and/or directors organize transportation, additional permission slips will be provided.

I acknowledge that there are inherent risks involved in attending such events, and I assume those risks and do hereby release and forever discharge BPF and the BPF Parties from any and all damages, expenses, liability, claims or demands for personal injury, sickness or death (including, without limitation, attorneys’ fees and expenses and including as a result of the negligence of any BPF Party), which may be incurred by the participant to the fullest extent permitted by law.

Without limiting the foregoing, in the event that the child-participant becomes ill or is injured and requires medical attention, I give BPF Parties the right to transport the child-participant and I authorize BPF Parties to seek medical treatment on behalf of the undersigned child-participant. The undersigned Parent/Guardian understands that BPF Parties will try to reach him/her prior to authorizing any medical treatment. In the event treatment is required from a physician and/or hospital personnel designated by BPF, I agree to hold the BPF Parties harmless from any claims, demands, or suits for damages arising from the giving of such consent. I also acknowledge that I will be ultimately responsible for the cost of any medical care, including but not limited to costs not reimbursed by my health insurance provider. I also agree to bring the child-participant home at my own expense should he or she become ill or injured or if deemed necessary by BPF
Parties.

I agree to indemnify and hold harmless the BPF Parties for any loss, cost, or damage caused by the undersigned participant during his or her participation in BPF events. I will assume the costs from damage caused by me or my undersigned child-participant at any BPF event. I give BPF Parties permission to photograph and use pictures and videos of the undersigned participant’s artwork, for any purpose deemed necessary by BPF, including, but not limited to, website posts, newsletters, news reports of various media, fundraising activities and advertising - online and in print - for BPF programs. I give BPF Parties permission to photograph, record, or film the participant, during the course of BPF activities and to use pictures and videos of the undersigned participant either alone or in groups, for any purpose deemed necessary by BPF, for BPF programs. Pictures and videos of the undersigned participant may be used for purposes including, but not limited to, website posts, newsletters, news reports of various media, fundraising activities and advertising - online and in print - for BPF programs. I understand that the participant may use electronic resources they own or that are provided by
BPF Parties, for internet access, for making art, music, or videos, for storing their work, or for connecting with members of our global groups, as a part of the program. Behavior and language in the use of these resources must be consistent with school, family, and community standards.

Electronic Communications and Communications Transmitted to and from Big Picture Foundation Inc
By visiting the BPF website or social media sites, by sending mail or emails to BPF, by transmitting forms to us, or by submitting information in other formats, you are knowingly and voluntarily consenting to receive communications from BPF Parties, electronically and by mail. We will communicate with you by email, by posting notices on our website or social media sites, or by mail. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

Any communication or material you transmit to BPF, via email, website, social media sites, online forms, by mail, or otherwise, including any data, questions, comments or suggestions, or the like (“Submissions”), is, and will be treated as, non-confidential, non-proprietary and will become the exclusive property of Big Picture, even if these Terms and Conditions or any other agreement you have entered into with us is later terminated or amended. We will not pay you or anyone else for any information that you provide which is used by us. Additionally, you acknowledge that you have full responsibility for any such submissions you make, including its legality, reliability, appropriateness, originality, and copyright.

Email *
Name of Parent/Legal Guardian Completing this Form *
First and Last Name of the Participating Child *
I would like BPF administrators to know this about my child’s allergies and other medical requirements, in case of emergency (while I indemnify and hold harmless the BPF Parties for personal injury, sickness or death, which may be incurred by the participant to the fullest extent permitted by law, while I am aware that BPF Parties will not monitor the child participant's medical needs at BPF events, and while I am aware that the following information may not be available to BPF Parties at events):
My child has permission to carry and to take the following medications, without supervision at BPF events:
(Only participants 18 years of age or older need sign below, though all other field must be completed. If the participant is under 18 years of age, both parents must sign, unless parents are separated or divorced, in which case the custodial parent must sign. The undersigned(s) represent(s) it/they has/have authority to sign under these conditions)
Student Participant's Age: *
Student Participant's Date of Birth:
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Student Participant's Address - house number & street
Student Participant's Address - town *
Student Participant's Address - state *
Student Participant's Address - zip code *
Student Participant's Address - country *
Parent /Legal Guardian Home Phone:
Parent /Legal Guardian Mobile Phone #: *
Emergency Contact Name: *
Emergency Contact Mobile Phone #: *
Emergency Contact Home Phone #:
I have read the entire statement above and I agree that it is true. *
Date *
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A copy of your responses will be emailed to the address you provided.
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