EmailMeForm
2025 Chalk the Block Registration
Thanks for Registering! A separate registration must be completed for every person that is participating. A Release of Liability and Photo Permission (see below) must be signed for each participant.
Participant Name
*
First
Last
Participant Phone (18 and up)
*
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Preferred Contact Person (required for 17 and under)
First
Last
Are you participating as a Team or Individual?
*
Team
Individual
Age of Participant or Team Captain (on day of event)
*
Age 5-8
Age 9-12
Age 13-18
19+
Birthday (Individual or Team Captain)
*
MM
/
DD
/
YYYY
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Email
*
Release of Liability and Photo Permission: I agree to indemnify and hold harmless Caldwell Fine Arts (hereinafter referred to as CFA), its Employees, Agents, Officers, Board Members, Volunteers, or any other person against loss or expense, including attorney fees, due to any bodily injury, personal injury or property damage which may result from any and all activities while participating in classes or any other activity sponsored by or conducted by CFA, or while visiting any facilities owned by, leased by, or controlled by CFA.
I give permission for myself or my child to be photographed and videotaped as part of this class/event/or rehearsal. Caldwell Fine Arts may use such photographs for any lawful purpose, including publicity, grant reporting, and advertising both in print and online without compensation or further permission.
It is understood and agreed that this Release of All Liabilities shall remain in force indefinitely. The release is recorded through a computer system, along with the date of agreement.
I am the person named below. I am 18 years of age. I am either the participant named below, or I am a parent/guardian acting on behalf of a child under 18 years of age.
Name
*
First
Last
Date Time
*
MM
/
DD
/
YYYY
Any special needs, comments or concerns?