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FLIM & PHOTOGRAPHY
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Class Liability Waiver
Students First Name
Students Last Name
Students Date of Birth
Does the student have a doctor’s permission to participate in physical activities?
Please specify anything we should know about including but not limited to Allergys or pre-existing medical conditions.
Parents/ Legal Guardians Initials
I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
Thanks for submitting!
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