Summer Fun Days at The Lot SEP 13, 2025 - FREE Arts Classes Registration Form
Thank you for your interest in this FREE day of Arts Classes! 

Please complete the registration form below to help us prepare. 
  • Participation Waivers can be filled out in-person on Saturday 9/13.
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What is your name? (Adult or Parent/Guardian) *
What is your phone number? *
What is your email address? *
What is the name of the participating student? (One form per student please) *
What is the age of the student? *
What 9/13 (9/20 rain date) classes are you registering for? *
Required
How did you learn about our classes? *
Required
Do you have any questions for us?

Participant(s) Liability and Food Allergy Waiver Form

I/we realize that participation in Moving History classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the participant(s)) assume all risks related to the use of any and all spaces used by Moving History, Inc. I acknowledge that despite precautions, there is an inherent risk of exposure to allergens that may trigger an allergic reaction in myself or my child. I understand these risks and voluntarily assume full responsibility for any adverse reaction or illness resulting from my or my child’s participation in the program and consumption of any food provided.

In consideration for my or my child’s participation in the program, I/we agree to release and hold harmless Moving History including its teachers, employees, volunteers, agents, and representatives from any and all claims, demands, damages, rights of action, or causes of action arising out of or related to any allergic reaction, injury, illness, or damage resulting from exposure to allergens, whether known or unknown, during the program.

I agree to indemnify and hold harmless Moving History and its representatives from any claims, damages, losses, or expenses, including attorneys' fees, arising from any allergic reaction experienced by myself or my child or any other individual related to food consumed by myself or my child.

I/we understand that Moving History are licensed, accredited and insured organizations. In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to the Executive Director, instructor or staff member as soon as possible. 


I/we and Moving History understand and agree to the aforementioned terms and conditions.

The use of a typed name is authorized below as a formal signature of approval.

Parent/Guardian: Please type your full name (first/last) below:
 *

Participant(s) Liability Waiver Form and Photo & Video Release 

Liability Waiver Form I/we realize that participation in Moving History classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the participant(s)) assume all risks related to the use of any and all spaces used by Moving History, Inc. 

I/we agree to release and hold harmless Moving History including its instructors/teachers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold Moving History liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Moving History. I give permission for my child(ren) to participate in any Moving History classes. 

I/we understand that Moving History are licensed, accredited and insured organizations. In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to the Executive Director, instructor or staff member as soon as possible. 


Photo & Video Release
I/we grant permission and consent to Moving History, Inc. for the use of photographs and videos containing my likeness for presentation under any legal condition, including but not limited to: publicity, copyright purposes, illustration, advertising, social media, and additional web content:

I/we understand that there shall be no payment for this photo and/or video release. 

I/we understand that no royalty, fee, or other compensation shall become payable to me by reason of such use. 

I/we understand that I may revoke this authorization at any time by notifying Moving History in writing. The revocation will not affect any actions taken before the receipt of this written notification. Images will be stored in a secure location and only authorized staff will have access to them. They will be kept as long as they are relevant and after that time destroyed or archived.

I/we and Moving History understand and agree to the aforementioned terms and conditions.

The use of a typed name is authorized below as a formal signature of approval.

Parent/Guardian: Please type your full name (first/last) below:
 *
Emergency Contact Name (First/Last) *
Emergency Contact Cell Phone # *
Emergency Contact Address *
What is the Emergency Contact's relationship to Student? *
I have voluntarily provided the above contact information to authorize Moving History and its representatives to contact any of the above on my child’s behalf in the event of an emergency.

The use of a typed name is authorized below as a formal signature of approval.

Parent/Guardian: Please type your full name (first/last) below:
 *
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