STEAM Fun LIABILITY WAIVER FORM
Please complete the waiver form if your kid joins a class / workshop / party at STEAM Fun.
WAIVER OF LIABILITY
In consideration of participation in a camp, class, workshop, or activity offered by STEAM FUN, I, the undersigned for myself and/or as the parent/guardian of the named Minor, agree to indemnify and hold STEAM FUN harmless and hereby waive, release and discharge any and all claims for damage, for death, personal injury, bodily injury or property damage which I and/or the Minor may have or which hereinafter may accrue to me and/or the Minor against STEAM FUN, its employees, agents, volunteers, independent contractors, and instructors from and against any liability arising our of or connected in any way with my and/or the Minor’s participation in this camp, class, workshop, or activity, even though that liability may arise out of negligence or carelessness on the part of the person or entities mentioned above.
I understand that accidents and injuries can arise from participation in this camp, class, workshop or activity; knowing the risks, nevertheless, I hereby agree to assume those risks on behalf of me and/or the above named Minor and to release and to hold harmless all of the persons or entities mentioned above whom (through negligence or carelessness) might otherwise be liable to me and/or the named Minor (or my/our heirs or assignees) for damages. It is further understood and agreed that this waiver, release and assumption of risks has been freely entered into and is to be binding on my/our heirs and assigns.
I have read and agree to the registration and program policies. Further, no video recording for any online classes offered by STEAM Fun due to the children's online privacy protection.
By my signature below, I acknowledge that I have read this document and understand its contents.
STEAM Fun
415 N. Mary Ave
#112
Sunnyvale, CA 94085
408-868-2587
https://steamfun.us
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Email address
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Your email
Parent/Guardian Name (Last, First):
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Your answer
Street Address (Please include city, state, and zipcode):
Your answer
Phone Number:
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Your answer
Emergency Contact Name:
*
Your answer
Emergency Contact's Phone Number:
*
Your answer
Child # 1 - Name (Last, First)
*
Your answer
Child #1 - Age
*
Your answer
Child #1: Any food allergy?
*
Your answer
Child #1: Gender?
Female
Male
Prefer not to say
Other:
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Child # 2 - Name (Last, First)
Your answer
Child #2: Gender?
Female
Male
Prefer not to say
Other:
Clear selection
Child #2 - Birth Date:
MM
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DD
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YYYY
Child #2: Any food allergy?
Your answer
Are you a parent or a guardian?
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Parent
legal guardian
Signature (Signature of a parent or legal guardian is required for youth registrations)
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Your answer
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