Arts in Motion
Community Youth Theater Arts Education, Inc.
2018 - 2019
Arts in Motion Release of Liability & Permission to Secure Treatment
I recognize and acknowledge that there are certain risks of physical injury to participants in Arts in Motion's program(s) and I agree to assume the full risk of any injuries, damages or loss regardless of severity which I or my minor child/ward may sustain as a result of participating in any and all activities connected with or associated with such program(s).
I agree to waive and relinquish all claims I or my minor child/ward may have against Arts in Motion (AIM) and its volunteers as a result of participation in the program.
I recognize that AIM is a non-profit, volunteer organization and serves children from grades Kindergarten through 12. As such, by virtue of our participation and membership in the organization, I agree to abide by the decisions made for the best interests of the organization and understand that while special requests may be made, they may not always be accommodated. Should a dispute or concern arise, I agree to bring it to the attention of the AIM Board first and attempt to work toward a mutual resolution. Should a mutual resolution not be reached, I hereby waive and relinquish any and all claims I or my minor child/ward may have against Arts in Motion and its volunteers and additionally agree that I will not publicly disparage the organization and/or its members, seek damages of any sort or file any suit or claim against Arts in Motion and/or its Board and/or its volunteers.
I do hereby fully release and discharge AIM and its volunteers from any and all claims from injury, damage or loss related to the activities of the program(s).
I further agree to indemnify and hold harmless and defend AIM and its volunteers from any and all claims resulting from injuries, damages, and losses sustained by me or my minor child arising out of, connected with, or in any way associated with the activities of the program(s).
In the event of any emergency, I authorize AIM to secure from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for me or my minor child/ward's immediate care and agree that I will be responsible for payment of any and all medical services rendered.
Name(s) of Child(ren)
Signature of Parent/Guardian
Print Name of Parent/Guardian
PO Box 762 Dade City, FL 33526
Telephone: 1-352-834-1AIM (1246)