Child #1 Name (hereinafter referred to as the “Participant/s”) *

First Name

Last Name

Child #2 Name (hereinafter referred to as the “Participant/s”)

First Name

Last Name

Child #3 Name (hereinafter referred to as the “Participant/s”)

First Name

Last Name

PARENT/GUARDIAN AUTHORIZATION AND ACKNOWLEDGMENT (REQUIRED) *

By submitting this waiver and consent, I, the legal parent/guardian of the Participant(s) grant permission for them to participate in all activities that make up Grass is Lava Summer 2023. I understand that Grass is Lava (hereinafter called the “Event”) experience will take place outdoors with a group of participants from the ages of 5-12. The group will be supervised by educator and instructor Arwyn Carpenter, a professional artist.

I agree.

ASSUMPTION OF RISKS *

I recognize and acknowledge that there are risks inherent to all activities. I agree to release and hold harmless FLIGHT: Prince Edward County’s Festival of Contemporary Dance and County Stage Company from any and all claims of injury which may result from my child’s participation in the Event. I acknowledge, agree and represent that there are risks inherent to all activities and I freely accept and fully assume all such risks, dangers and hazards and the possibility of personal injury, harm, death, property damage or loss, resulting there from, and responsibility for losses, costs and damages, however caused, that may incur as a result of the Participant(s) participation in the Event. I hereby agree to waive any and all claims that I have or may in the future have against FLIGHT: Prince Edward County’s Festival of Contemporary Dance and County Stage Company and any additional sponsors and/or venues of the Event, along with their directors, officers, employees, volunteers, members, agents, and contractors.

I agree.

MEDICAL CONSENT *

FLIGHT Festival and Festival Players of Prince Edward County will make every effort to contact the emergency contacts I have listed below in the case of an emergency.

I consent.

Emergency Contact Name *

First Name

Last Name

Emergency Contact Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone *

(###)

###

####

TERMS *

CODE OF CONDUCT All participants are expected to maintain an acceptable level of conduct at all times. Misconduct is defined as discrimination and harassment of any kind relating to a person’s age, gender, sexual orientation, religion, race, colour, disability, national origin, ethnic background, or level of experience. Any participant who feels subjected to harassment or discrimination during the course of their time at the camp should bring the matter to the attention of County Stage Company as soon as possible. The complaint will be investigated, and appropriate action will be taken. PANDEMIC RESPONSE PLAN All participants will be kept informed regarding protective actions and/or modifications related to the pandemic. All participants must follow guidance and interventions mandated by the Province of Ontario and/or the Hastings Prince Edward Health Unit. Pandemic information will be shared via email distribution. I hereby accept all the above terms of this participation waiver for Grass is Lava.

I accept.

MEDIA RELEASE (OPTIONAL BUT STRONGLY RECOMMENDED) *

In consideration of my child's/children's participation in the Event, I hereby grant permission to both the Flight Festival and County Stage to utilize photographs, video, and excerpts of creative work of/from my child(ren), for the purposes of promotion, reporting, or publication. Any of these parties may use my children's name when distributing such material. I understand that no royalty, fee, or compensation of any kind shall become payable to me or my child(ren) by reason of such release and use of my child’s likeness. Such distribution may happen on social media platforms, websites, and documentation for research or artist conferences and presentations. Flight Festival will always inform my child(ren) in advance and seek their consent before recording any experience as part of the artistic process that may be later used in these ways.

I consent.

I do not consent.

Parent/Legal Guardian Name *

First Name

Last Name