CREATE Camp Checklist & Disclaimer Form
The intention of this checklist is to provide clarity regarding the guidelines CREATE is following to keep your child and the whole CREATE community safe and healthy while participating in our ONSITE Summer Art Camp this summer. Although you must complete a separate health screening form for each child, this Parent Checklist & Disclaimer form can be completed once per family.

Before you complete this checklist, please make sure you have read and understand our Health & Social Distancing Plan for Summer Camp: Policies & Procedures at https://createartscenter.org/wp-content/uploads/2021/01/2021_Health_Social_Distancing_Plan_for_Summer_Camp.pdf
Email address *
Camper #1 First Name *
Camper #1 Last Name *
Camper #2 First Name
Camper #2 Last Name
Camper #3 First Name
Camper #3 Last Name
I understand that: *
(All boxes must be checked)
Required
CREATE ARTS CENTER CORONAVIRUS/COVID-19 LIABILITY WAIVER ACKNOWLEDGEMENT AND RELEASE AGREEMENT (Please read in its entirety )
This Liability Waiver Acknowledgement and Release Agreement (“Agreement”) is between CREATE Arts Center (“CREATE”), the customer of CREATE that has agreed to this Agreement (“Participant”), and the Parent or Guardian of the Participant (if the Participant is under the age of 18) and is made on the date indicated below.

The novel Coronavirus SARS-Cov-2 (“COVID-19”) is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing as a means to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in CREATE programs or accessing CREATE facilities could expose the Participant to COVID-19. CREATE in no way warrants that a COVID-19 infection will not occur through participation in CREATE programs of accessing CREATE facilities.

AGREEMENT OF RELEASE AND INDEMNITY; NO LIABILITY: I (as the Participant (and their Parent or Guardian if under the age of 18) acknowledge and agree that: CREATE has made no representation or warranty regarding COVID-19; and CREATE shall not undertake responsibility, nor shall it be liable for the actions of me (the Participant) or any party regarding COVID-19. I (as the Participant or their Parent or Guardian if under the age of 18) further acknowledge and agree that CREATE and its officers, employees, staff, agents, servants, the owner of the venue of any part of the program, sponsors, or independent contractors shall not be responsible for any loss, costs, damages, consequential or punitive, or liability incurred by Participant of any nature including, but not limited to, those arising from any form of negligence, gross negligence, strict liability, reckless misconduct, intentional torts, personal injury, or criminal activity; and I (as the Participant or their Parent or Guardian if under the age of 18) waive my right to seek such legal redress for these causes of action. Participant (and their Parent or Guardian if under the age of 18) shall indemnify, defend, and hold CREATE, its officers, employees, staff, agents, the owner of the venue of CREATE’s program and events, servants, sponsors, or independent contractors harmless from and against all liability, whether intentional or otherwise, in connection with or arising from his or her participation in the program and events including, but not limited to, any claims of a breach of this Agreement.

ACKNOWLEDGEMENT OF RISKS: By participating in any CREATE’s programs or events, I (as the Participant or their Parent or Guardian) acknowledge that there is an element of risk in regarding COVID-19, and I (as the Participant or their Parent or Guardian) acknowledge and agree that there are dangers and rigors imposed by such programs and events regarding COVID-19. Knowing and understanding these risks, I (as the Participant or their Parent or Guardian) agree to fully assume all risk of illness, injury or death, and release and hold harmless CREATE, its officers, employees, agents, servants, independent contractors, vendors and suppliers from all actions, claims or demands for damages for personal injury, consequential or punitive damages, costs or expenses resulting from any issues related to COVID-19. I (as the Participant or their Parent or Guardian) understand that the Participant has the option to cease participation in any program and events if the Participant feels unsafe. The Participant further agrees to bear the expense of voluntarily withdrawing or ceasing participation in any program and events before it is concluded.

I (as the Participant or their Parent or Guardian) acknowledge and agree that the Participant (and their Parent or Guardian if under the age of 18) was provided with this Agreement prior to the Participant’s attendance at any of the program or events, and that Participant (and their Parent or Guardian if under the age of 18) had the option to forgo the program and events without agreeing to the terms in this Agreement.

I (AS THE PARTICIPANT OR THEIR PARENT OR GUARDIAN) HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND THAT IT CONTAINS, AMONG OTHER THINGS, A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW OF CREATE, ITS OFFICERS, EMPLOYEES, AGENTS, SERVANTS, INDEPENDENT CONTRACTORS, VENDORS AND SUPPLIERS, AND CONSTITUTES A LEGALLY BINDING CONTRACT BETWEEN ME AND CREATE. MY ELECTRONIC SIGNATURE BELOW IS OF MY OWN FREE WILL AND I (AS THE PARTICIPANT OR THEIR PARENT OR GUARDIAN) AGREE TO ALL STATED CONDITIONS, RELEASES AND LIMITATIONS OF LIABILITY.
Please check the box to acknowledge and agree to the waiver above: *
Required
PARENT OR GUARDIAN: By entering your name in the box below, you are effectively providing your signature, indicating that you agree to all stated conditions, releases, and limitations of liability. *
Date: *
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A copy of your responses will be emailed to the address you provided.
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