Books & Breakfast Registration
Register your child for Books & Breakfast 2018
Name of participant
Name of participant
Does child have any food allergies?
Relation to child
What dates will your child be attending books and breakfast? (Check all that apply)
June 23rd, 2018
June 30th, 2018
July 7th, 2018
July 14th, 2018
July 21st, 2018
July 28th, 2018
August 4th, 2018
August 11th, 2018
Any additional information you would like us to know about your child (Optional)
I hereby certify that I am the adult parent or guardian of the participant, a minor child under the age of eighteen years, and I consent to his/her participation in recreational activities at Books and Breakfast Event hosted by Freedom Inc. at 1810 South Park Street; Madison, WI 53713. I acknowledge and agree that his/her participation in Books and Breakfast is voluntary. To the fullest extent allowed by law, I hold harmless and agree to indemnify Freedom Inc., its officers, directors, faculty, staff, volunteers, employees and agents, from and against any present or future claim, cause of action, loss or liability for injury to person or property, which said minor child may suffer or for which said minor child may be liable to any other person, related to said minor child’s participation, resulting from any cause whatsoever, and regardless of fault. (sign below that you agree)
I give permission to Freedom Inc. to use above named child’s photo or video, and likeness for the purpose of promotion by Freedom Inc. for all forms, media and manners, for the following, but not limited to, news releases, photographs, video, audio, website, marketing, advertising, trade, promotion, exhibition for an indefinite period of time. (sign below that you agree)
This is a complete release of liability and a legally binding contract. This Agreement is to be construed as broadly as possible. Participant signs this Agreement of his/her own free will and agrees to be bound by it, from the date of his/her signature, forever into the future (sign below that you agree)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service