Camps Waiver & Liability Release Form

Medical History and Student Insurance Information

Yes   No

Yes   No


 
 

PLEASE NOTE THAT WE CANNOT PROVIDE STUDENTS WITH ANY MEDICATION, NOT EVEN ASPIRIN. STUDENTS MUST PROVIDE THEIR OWN.

In addition to the home, cell and work numbers you provided on the initial application, please provide any alternate phone numbers we should have in case we are unable to reach you at one of these numbers. This could be your spouse’s or partner’s cell or work, or the number of a nearby friend or relative.

Liability Waiver and Model Release Statement

I, the undersigned, waive and release any and all claims for myself and my heirs against Blue Bear School of Music, and any of its officers, directors, employees, agents or sponsors for any injuries or illnesses which may directly or indirectly result from participation in our classes. This waiver and release is valid from the date of my signature below, and shall remain effective unless and until modified in writing by the undersigned.

I understand that Blue Bear may, from time to time, photograph student work in the classroom for marketing and archival purposes. In the event that a photographer comes to my class, I acknowledge that it is my responsibility to notify the photographer of my desire not to be photographed. I hereby grant Blue Bear School of Music permission to use photographs in which I appear for marketing, communications, and/or archival purposes. I waive any right to inspect or approve the finished product, including written copy that may be created in connection therewith. It is my understanding that such photographs will be copyrighted by the photographer and that no charge or special compensation is or will be required for my service/s.


 

A PARENT OR GUARDIAN MUST READ THE ABOVE AND SIGN THE FOLLOWING:

By submitting this form online, I certify that I am the parent or guardian of the minor named above and have the legal authority to execute the above release and approve the foregoing.