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Parent/Legal Guardian Waiver & Liability
Registration Form

I hereby give my permission for my child(ren) to participate in the informal Wild Arts Learning Art Program (hereto forward referred to as Program) activities hosted by Program Director, Cina Canada (hereto forward referred to as Program Director).
Yes
No
I understand and consent that participation in this program involves activities that expose my child(ren) to certain risks and dangers. Accidents and injuries are always possible and I consent even so to all program activities.
Yes
No
I understand and consent that if my child(ren) has any conditions that would make it unsafe for him/her to participate in this program, I will withdraw the application of my child(ren) for the Program.
Yes
No
I understand and consent that my child will be participating in various outdoor activities, preparing natural, homemade art supplies with raw materials, and eating and drinking snacks and beverages provided by Wild Arts Learning.
Yes
No
I understand and consent that my child will be foraging and tasting wild edibles in the wild culinary arts segment of the program. I understand that it is my responsibility to alert Program Director to any allergies or food/beverage aversions.
Yes
No
I understand and consent that my child will be engaged in various activities that require time in the water, grass and woods and that I am responsible to send non-toxic bug spray and sunscreen for my child(ren).
Yes
No
I understand and consent that my child(ren) may be excluded from all activities in the event that my child(ren) fails to abide by the Wild Arts Learning policies and rules, or impedes or interferes with the operations of the Program.
Yes
No
I understand and consent that if my child(ren) threatens the health, safety or welfare of other participants or staff, they will be excluded from the Program and no refund of any fees will be made.
Yes
No
I understand and consent that Program Director or staff will make every effort to contact me in the case of an emergency. In the event of an emergency, I give my permission for Program Director or staff to call emergency services, if needed.
Yes
No
I understand and consent to emergency services administering any critical or life-saving medical treatment for my child(ren) while at the Wild Arts Learning program, onsite or offsite if taken from Program site for medical attention.
Yes
No
I accept responsibility for the costs of all such medical attention and treatment and understand that I am responsible to alert Program Director of my child(ren)'s medical issues, conditions and allergies, in writing, prior to the start of the program.
Yes
No
I grant permission to Wild Arts Learning to utilize my child(ren)’s photo/video appearance for the purpose of promotion, reporting or publication for Wild Arts Learning. If I do not consent, I will alert Program Director prior to the Program.
Yes
No
I understand/consent that by signing this Waiver & Release of Liability, I hereby voluntarily release and forever discharge Wild Arts learning from any/all legal or financial responsibility resulting from my child(ren)'s participation in the Program.
Yes
No
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