Camp BizGym Registration & Parental Consent Form

Camp BizGym Parental Consent

GENERAL: This Consent hereby grants permission for Students listed below to participate in the 2014 Camp BizGym summer camp. Students will make scripts and original videos for a business. Camp BizGym and Mid Pacific Institute will provide continuous supervision during official camp hours. Daily transportation to and from the site is the sole responsibility of respective Parents/Guardians (“Undersigned”).

INSURANCE: Camp BizGym activities will take place under the guidance and direction of the BizGym Foundation and Mid Pacific Institute. Event and liability insurance are being provided by the BizGym Foundation.

MEDICAL EMERGENCIES: Parents/guardians assume all responsibility for the health of their respective Students. In the event of an emergency, telephone numbers as listed below may be used to contact Parents/Guardians for instructions.

IMAGES: Photos and videos taken at various Camp BizGym events may be posted to various publicly disseminated media. The Undersigned hereby grant Camp BizGym and its designees the right to use their respective child’s name, likeness, image, voice, appearance, and performance in Content whether recorded on or transferred to videotape, film, slides, photographs, audio tapes, or other media, now known or later developed. This grant includes without limitation the right to edit, mix, or duplicate and to use or re-use Content in whole or part as Camp BizGym may elect. Camp BizGym or its designee shall have complete ownership of Content, including copyright interests, and the Undersigned acknowledge they have no interest or ownership in Content or its copyright. The Undersigned also grant Camp BizGym and its designees the right to broadcast, exhibit, market, sell, and otherwise distribute Content, either in whole or in part, and either alone or with other content, for commercial or non-commercial television or theater, closed-circuit exhibition, Internet distribution, home video distribution or any other purpose that Camp BizGym or its designees in their sole discretion may determine. This grant includes the right to use Content for promoting or publicizing any of the uses. The Undersigned hereby gives all clearances, copyright and otherwise, for the use of their respective child’s name, likeness, image voice, appearance and performance embodied in the Content. The rights granted Camp BizGym herein are perpetual and worldwide.

HOLD HARMLESS & INDEMNIFICATION: The Undersigned agree to remain legally responsible for any and all personal actions taken by their respective Students named below along with team mentors, friends, family and others associated with team entries. The Undersigned agree on behalf of themselves and their respective Students named herein to hold harmless and defend Camp BizGym, its designates, sponsors, officers, committee members, employees, and agents from any and all claims known and unknown arising out of or in any way connected with the event with respect to any and all actions, claims or demands that may be made or brought arising from or in connection with their respective Student attending or participating in Camp BizGym events or in connection with any illness or injury or cost of medical treatment in connection therewith, and agree to compensate Camp BizGym, its designates, sponsors, officers, committee members, employees, and agents reasonable attorney’s fees and expenses arising in connection therewith. The Undersigned herein confirm that each has respective rights to enter into this Agreement, and that each is not restricted by any commitments to third parties. The Undersigned expressly release and indemnify Camp BizGym, its designates, sponsors, officers, committee members, employees, and agents from any and all claims known and unknown arising out of or in any way connected with the above granted uses and representations.

Student Name*

First Last

School (Fall 2014)

Grade (Fall 2014)*

Allergies

Medications

Dietary Restrictions

Parent Name*

First Last

Parent Email*

Parent Phone*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Acknowledgement*

I acknowledge they have read, understand and agree to the foregoing terms.

CAPTCHA

Registration & Parental Consent Form

Share this: