EmailMeForm
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.
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, amage of loss to me or my personal property which may arise.
I have read the entire informed Consent and Release and accept the conditions herein as a requirement to participation in this program.
Name of Participant:
First
Last
Name of Parent/Legal Guardian (if under age 18):
First
Last
Date:
*
MM
/
DD
/
YYYY
Signature: Child signs if 18 or over
*
Clear
PHOTO & VIDEO RECORDING RELEASE:
I give permission to WaCPAC for publication of photos (Facebook, website, and brochure), video and recordings taken of my child while participating in any rehearsals, performances and any other activities offered as a part of this production. I understand that I will not be paid any royalty or other compensations; and I relinquish any right I may have to any payment if my child’s photo, video or recording is published.
As part of auditions, I understand my child’s photo will be taken for identification purposes. Photos will be solely for the directors’ use in casting and will not be shared.
I have read the entire Photo Release and accept the conditions stated herein as a requirement to participation in this program.
Name of Participant:
First
Last
Name of Parent/Legal Guardian (if under age 18):
First
Last
Email
Signature: Child signs if 18 or over
*
Clear
Date:
*
MM
/
DD
/
YYYY
