LIABILITY WAIVER FORM:

As the parent or legal guardian of the above child, who is a minor child under the age of eighteen (18) (hereinafter “my Child”), and in exchange for the benefits to be derived by my Child’s participation in this Activity, by Miss Alicia Art classes, I hereby agree, on behalf of myself and my child, to the following: I hereby grant my permission for my Child to participate in the Activity. I am fully aware of the risks and hazards connect with my Child’s participation in the Activity, and hereby elect to allow my Child to voluntarily participate in the Activity, knowing that the Activity may be hazardous to my Child or to his or her property. On behalf of myself and my Child, I VOLUNTARILY ASSUME ALL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, that may be sustained by my Child, or any loss or damage to property owned by myself or my Child, as a result of my Child being engaged in the Activity, WHETHER CAUSED BY THE NEGLIGENCE OF THE ORGANIZATION OR ITS VOLUNTEERS, AGENTS, or otherwise. On behalf of myself and my Child, as well as our respective estates, heirs,

administrators, executors, and assigns, I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Miss Alicia (Alicia Campos), or volunteers (hereinafter “RELEASEES”) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, that may be sustained by me, or my Child, to any property belonging to me or my Child, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES or otherwise, while participating in the Activity. It is my express intent that this Release and Hold Harmless Agreement (hereinafter “Agreement”) shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this Agreement shall be construed in accordance with the laws of the State of Florida.