Liability Waiver and Photo Release

RELEASE OF LIABILITY AND INDEMINIFICATION - In consideration for Brain Builders STEM Education, Inc(BBSE) acceptance of this registration, I hereby agree to indemnify and hold harmless BBSE, its officers, agents, or employees from any liability or claim or action for damages resulting from or in any way arising out of the participation in any BBSE classes, programs, camps, birthday parties by the person registered. I further understand and agree: (1) to assume all risks inherent in the activities which are available and in which l may participate, and understand that these activities involve risk to my person and property and (2) to assume the risks, if any, arising from the conditions and use of equipment and facilities. l further understand and agree that there may be risks and dangers not known or reasonably foreseeable at this time. I understand and agree that included within the scope of this release is any cause of action, arising from the performance of, the failure to perform maintenance, inspection, supervision or control of equipment and facilities, or the failure to warn of existing dangerous conditions not known to or reasonably discovered by the BBSE, including all acts of negligence of the BBSE. In the event of injury or illness while the participant is attending the recreation activity, l hereby authorize the BBSE to consent to medical treatment on behalf of my child as deemed necessary. The undersigned, as parent or legal guardian of the child identified on this form, hereby authorizes BBSE and its officers, employees and agents into whose care the registered child has been entrusted, to consent to the advice of trained Orange County Fire Authority personnel. This authorization to consent to treatment of the minor identified above is given to the BBEP in conjunction with any activity or event in which the minor's care is entrusted to BBSE.

 

PHOTO RELEASE - BBSE may take, use, and publish photos of participants for publicity purposes. Photos of participants are used in BBSE’s website, and media publications (i.e. flyers or video streams) to promote recreation classes and programs, I hereby grant BBSE permission to use my likeness, name, voice and words in any broadcast, telecast or print media account of this event or activity free of charge. IF THE PARTICIPANT IS A MINOR, his or her custodial parent or legal guardian must read and execute this agreement. I hereby warrant that I am the custodial parent or legal guardian of the participant listed above, who is a minor, on my own and said minor’s behalf to the terms and conditions of the foregoing release. If you do not want any photos of your child to be used by BBSE, initial here ____________ PRIVACY

 

STATEMENT: BBSE takes your privacy seriously. Instructors will receive only the name, current age, and phone number of participants. E-mail addresses will only be utilized for BBSE correspondence related to your registration, promotions, and to inform you of upcoming events. Unless required by court order, your information will not be shared with other agencies, departments, businesses, or individuals. If you feel that your rights and privacy have been violated, please contact BBSE at 714-360-1101.

Call Us: 714-360-1101   /   info@BrainBuildersED.org   /  PO Box 2787 Costa Mesa, 92628

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