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ROME AREA COUNCIL FOR THE ARTS & ROME INTERNATIONAL FILM FESTIVAL STUDENT SCHOLARSHIP PERMISSION FORM AND RELEASE I,___________________________________, am the parent or guardian of, and give permission for said child to attend the 2018 Rome International Film Festival (RIFF) as a Rome Area Council for the Arts Student Scholar (RACA Student Scholar). By giving this permission, I understand that RACA Student Scholars will attend portions of RIFF on Thursday, November 1st, Friday, November 2nd, Saturday, November 3rd and/or Sunday, November 4th, 2018. RACA Student Scholars or their parents or guardians will be responsible for providing or securing transportation to and from RIFF on the above dates, and I understand that the Rome Area Council for the Arts (RACA) and the Rome International Film Festival do not assume any responsibility for issues relating to transportation to or from RIFF or for issues relating to parking during RIFF attendance. I understand that most of the films shown at RIFF are unrated, and some of the films may contain graphic, sexual, or violent content. I understand that RACA Student Scholars will have the opportunity to purchase concessions during intermissions and/or between films but that RIFF and RACA assume no responsibility for providing meals, snacks, or beverages to RACA Student Scholars. I also understand that RACA Student Scholars may be photographed at RIFF screenings or events in connection with their participation as a RACA Student Scholar. I hereby give permission for any photographs of myself and/or my child, taken in connection with his or her participation as a RACA Student Scholar, may be used by RIFF or RACA in connection with media releases, website publicity, or social media posts. Further, I hereby grant RIFF and RACA, their board of directors, and its members (collectively, RACA and RIFF) permission to use and display my child’s film reviews in any and all of its publications, including website entries and social media, and at RIFF or RACA events, without payment or any other consideration. I hereby hold harmless and release and forever discharge RIFF and RACA from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I have read this Permission Form and Release and I fully understand its contents, meaning, and impact. __________________________________________ (Student’s Signature)

_________________________________________ (Date)

__________________________________________ (Student’s Printed Name)

_________________________________________ (Student’s E-mail or Phone #)

__________________________________________ (Parent/Guardian’s Signature)

_________________________________________ (Date)

__________________________________________ (Parent/Guardian’s Printed Name)

_________________________________________ (Parent/Guardian’s E-mail or Phone #)

__________________________________________ (Teacher’s Name)

_________________________________________ (School)

__________________________________________ (Student Grade)

_________________________________________ (Teacher’s E-mail Address and Phone #)

RACA & RIFF STUDENT SCHOLARSHIP PERMISSION FORM  
RACA & RIFF STUDENT SCHOLARSHIP PERMISSION FORM  
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