G.I.R.L.S. ROCK SACRAMENTO

gender inclusivity through radical love and support

LIABILITY + PHOTO RELEASE

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Full name of participant (if different than above)

Please describe the class, camp, or event that the participant will be attending or mentoring

Example: Summer Camp, Workshop, etc.

Is the participant under 18?

I acknowledge that either I and/or my child will be participating in or mentoring at a camp, class, or program offered by GIRLS Rock Sacramento and hereby waive, release, and hold GIRLS Rock Sacramento harmless from all claims, demands, causes of action, liabilities, losses, damages and costs that may arise from any and all injuries and damages sustained while at GIRLS Rock Sacramento.

Photographs of those involved with our programs, whether as campers or crew, are used for promotional purposes. However, Girls Rock Sacramento will not publish photographs of participants without permission. Please consider the following waiver: I give Girls Rock Sacramento permission to photograph myself/my child and use my/my child's likeness to promote Girls Rock Sacramento in print and online. I understand such images will only be used to promote these education programs and I hereby give my permission to use such material without further claim on my part.

By typing my full name below, I acknowledge that I am an adult representing either myself or my child, I have read and understood the terms of this waiver, and voluntarily agree to release GIRLS Rock Sacramento from any and all liability for injuries or damages that may occur while at GIRLS Rock Sacramento.

Date

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