Consent Form 2010-2011 1. 2. 3. 4.
I/we have read and understood the 2010-2011 Student/Parent Handbook and agree to abide by the regulations stated therein. I/we understand that this agreement must be signed before my/our child can attend Idyllwild Arts Academy. I/we understand that Health forms must be completed and returned prior to registration, that this information is confidential and is to be used solely for evaluating the health status of my/our child. I/we permit my/our child to participate in on-and off-campus field trips and tours sponsored by Idyllwild Arts Academy including transportation provided by the School and its Staff.
Exclusions, if any:___________________________________________________________________________ 5.
I/we understand that my/our child may participate in supervised general exercise classes and activities including but not limited to the following list: Swimming Bicycling Dance Basketball
Baseball/Softball Soccer Ultimate Frisbee Weight Training
Volleyball Yoga Cross Country Tennis
Wilderness Activities Exercise Walking Hiking/Jogging Badminton
Exclusions, if any:___________________________________________________________________________ 6.
7.
I/we understand that students at Idyllwild Arts Academy frequently participate in public performances, some of which may be videotaped, recorded or photographed. In addition, students may participate in other pursuits, commercial or otherwise, that may be filmed, videotaped, recorded or photographed, including without limitation, television, and other, projects that may be proposed to the School (hereinafter all such matters shall be referred to collectively as “performances”). I/we hereby authorize and consent to participation of my/our child in such performances and also irrevocably consent to and authorize the use by Idyllwild Arts Academy, or anyone authorized by Idyllwild Arts Academy, of any performances or parts of performances so videotaped, filmed, recorded, or photographed for such reasonable purposes as Idyllwild Arts Academy may wish, including the right to make adaptations of any kind based on such material, and to use such material in publicity on behalf of Idyllwild Arts; and, in addition, I/we hereby release and discharge Idyllwild Arts Academy from any and all claims and demands which I/we and my/our child may have, or may have in the future, relating to the child’s participation in such performances and in connection with the use of any videotaped, filmed, recorded or photographed material based on such performances, including but not limited to, any and all claims of libel, slander and invasion of privacy. I hereby represent and warrant that: (a) I am over 18 years of age; (b) I am competent to contract in my own name in the above regard; and (c) I have read the forgoing and fully understand and agree to the contents thereof. If I am under the age of 18, the appropriate consent of my parent(s) or guardian(s) is granted below. Such parent(s) or guardian(s) hereby represents and warrants that he/she has full legal capacity to contract for the minor named herein and that the parent(s) or guardian(s) has read the foregoing, fully understands and agrees to the contents thereof and confirms that it is in the minor’s best interest. I have read, understand and agree to all of the above:
____________________________________________________ Signature of Parent/Guardian
_______________________________ Date
____________________________________________________ Signature of Parent/Guardian
_______________________________ Date
____________________________________________________ Signature of Student
________________________________ Date
IdyllwildARTS ACADEMY
REVISED 04/07/10 STUDENT SERVICES
P.O. BOX 38 * 52500 TEMECULA DRIVE * IDYLLWILD * CALIFORNIA * 92549 * (951) 659-2171 * FAX (951) 468-7060