Camp #4: Hickory Park Photography Camp- (6/30 - 7/1) - 9am-Noon

I, the undersigned ask that I be admitted to participate in photography classes sponsored by The Photography Workshop, Inc. In consideration of such admission, I/we do hereby agree to release, discharge, and hold harmless The Photography Workshop, Inc., its officers, agents, and employees, hereafter referred to as “Releasees”, of any and from all causes, liabilities, damages, claims, or demands whatsoever on account of any injury, accident or death involving myself arising out of my attendance at The Photography Workshop, Inc. classes. I understand and acknowledge by participating in this activity, the risk of injury and/or death exists. I hereby give the Releasees my consent that any photographs, films, audio and visual recordings taken during the class may be used by The Photography Workshop, Inc., its assigns or successors, in whatever way they may desire, including newspaper, audiovisual productions, television, radio, Internet and other public relations purposes without any notice or without any compensation. I agree to cooperate with all rules, regulations and instructions from Releasees and understand that if I do not I may be dismissed from class with no refund. I understand that the Releasees cannot be responsible for loss or damage of any valuables including but not limited to clothing, jewelry, computers, cameras or other electronic devices. I understand that my photography equipment and/or personal belongings could be damaged during the class by a number of factors that include, but not limited to, natural forces such as rain, wind, sand, or other factors such as falling with or dropping my equipment. These risks and dangers may also be caused by my own actions, or inactions, the actions or inactions of others participating in the workshop. There may be other risks and social and economic losses either not known to me or not readily foreseeable at this time. I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation in the class. I am aware that are inherent dangers in participating in this photography class with the Releasees, including, but not limited, to driving, hiking, photographing outdoors, accident or illness. I understand that this class involve risks and dangers of serious bodily injury, as well as risks and dangers to my photography equipment. My personal safety cannot be guaranteed. I certify that I am in reasonably good physical condition and health to participate in this class.

I/We, the undersigned, as the parent or legal guardian of above named camper, in consideration of the request, give permission for my child to participate in photography camp activities at The Photography Workshop, Inc. I/We understand and acknowledge by allowing my child to participate in this activity, the risk of injury exists and medical treatment may be necessary. I/We understand that I/We will be notified if my child, listed above, becomes ill while at camp. I/We agree that upon notification of my child’s illness, I/we will agree to have him/her picked up as soon as possible. In the case of an emergency when I/we cannot be reached, I/we hereby give authorization to the The Photography Workshop, Inc, its employees and agents, and any treating physician of any medical facility to obtain or provide whatever medical treatment deemed necessary for the immediate welfare of my child, listed above. I/We give permission for The Photography Workshop, Inc. to release any information on this form to any healthcare provider. Conditions of Enrollment: I/We understand it is my responsibility to provide accident and health insurance coverage for my child and I/we will be financially responsible for all charges and fees for any and all medical treatment, regardless of whether my medical insurance covers such charges and fees. I/We understand that The Photography Workshop, Inc. does NOT provide any medical insurance and I/we will not hold The Photography Workshop, Inc. financially responsible for any medical treatment.