Consent Form

Name of Student *

First Name

Last Name

Who is filling out this form? (Click on one) *

Student

Mother

Father

Legal Guardian

Parent or Legal Guardian Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Consent (required for all students under 18) *

As guardian and/or parent, I understand that I assume full responsibility for how and with whom my child arrives or departs from the Studio (Please click on "Agree")

Agree

Liability Agreement *

I waive all rights to any legal action against The Studio or its instructors in the event of injury, damages, or loss of personal property not caused by or resulting from the negligence of the owner or operators, employees, volunteers, or persons in charge of The Studio

Agree

Photography Release *

I consent to and authorize the use and reproduction by The Studio or anyone authorized by The Studio of any and all photographs that have been taken of me or my child or any work of art produced by me or my child without compensation to me. All photo images are owned by The Studio. I hereby acknowledge that I have read and understood the terms of this release.

Agree

Photography Consent to Publish *

I hereby give consent to The Studio to use, in any of its print or electronic publications, any photographs taken by Studio staff, volunteers, or persons authorized by the Studio.

Agree

Disagree

Right to Refuse Service *

I understand that The Studio reserves the right to refuse service to any student for reasons such as, but not limited to, disruptive or unsafe behavior, or behavior unsuitable for the comfort of the classroom environment.

Agree