EmailMe Form - Consent / Release Form

INFORMED CONSENT & RELEASE:
I recognize that my child’s participation in any rehearsal, performance and any other activities offered as a part of WaCPAC’s Theater program is not without some risk. I hereby certify that I now of no medical condition that would increase my child’s risk of illness or injury as a result of participating in this program. In case of emergency, I consent to the administration of first aid and/or the dispatching of 911 emergency services. Initial here:

I hereby release and hold harmless WaCPAC, its agents and independent contractors from any and all liability, damage, expense, causes of action, suits, claims or judgements, arising from injury, damage or loss, or claims of injury, damage or loss to me or my personal property which may arise. Initial here:

I have read the entire informed Consent and Release and accept the conditions herein as a requirement to participation in this program. Initial here:

Name of Participant: *

First Last

Name of Parent/Legal Guardian (if under age 18):

First Last

Electronic Signature (full name): *

Date: *

MM / DD / YYYY