CERTIFICATION OF PHYSICAL FITNESS/MEDICAL CONSENT
I allow my child to participate in physical fitness activities at Camp MusArt LLC. Physical fitness activities include, but are
not limited to: dance classes, ball games, yoga, playground activities, and any other outdoor/indoor physical activities that
may be offered by Camp MusArt LLC. I fully understand the level of physical activity involved in these programs and
certify that my child is physically fit, and there are no medical reasons why she/he cannot participate in these programs. I,
the undersigned parent or guardian, understand that an emergency situation may arise where the delay of medical or
surgical procedures could endanger the well-being of my child. I do hereby grant permission to the staff of Camp MusArt
LLC to render judgment in my absence concerning medical assistance or hospital care in the event of accident or illness. I
understand that Camp MusArt LLC will not administer any medications to my child.
I, the undersigned parent or legal guardian for (Name of Camper/Student)
Child One (the "Child"), in enrolling my child in Camp MusArt LLC’s programs and activities for the term, understand and voluntarily agree that the Child is participating in the programs and activities and using the premises, including but not limited to the outdoor playground, at her/his own risk. I further understand and knowingly acknowledge that participation in Camp MusArt LLC’s programs and activities is voluntary and contains some element of risk. Understanding that risk, for myself and for the Child I voluntarily and knowingly release Camp MusArt LLC and its members, managers, officers, contractors, teachers, staff, employees, and volunteers from any and all liability and damages whatsoever arising from any personal injury or property loss sustained by the Child while participating in any Camp MusArt LLC programs or activity on or off the premises, whether caused by the negligence of Camp MusArt LLC’s managers, members, officers, contractors, employees, staff, teachers, and volunteers or not. For myself and for the Child, I agree and voluntarily assume all risks and full responsibility for any and all personal injuries, damages, and property loss that may occur while the Child is participating in any Camp MusArt LLC program or activity on or off the premises. For myself and for the Child, I do hereby fully and forever voluntarily release, discharge, hold harmless, and waive any liability of Camp MusArt LLC and its managers, members, officers, contractors, employees, staff, teachers, and volunteers from and for any and all claims, demands, damages, rights of action, penalties, lawsuits, and attorneys’ fees and costs, present or future, resulting from or arising out of the Child’s participation in any programs, activities, and/or use of Camp MusArt LLC’s facilities or premises. Initial Date
Jun 05, 2023
I understand, warrant, and covenant that I am intentionally and freely waiving and releasing my rights and the rights of the Child to the fullest extent allowed by North Carolina law in this regard and do so voluntarily and knowingly in order that the Child may participate in Camp MusArt LLC’s programs.
Jun 05, 2023
Prior to voluntarily agreeing to and signing this release and waiver, I have been given the opportunity to review and inspect and have reviewed and inspected the premises and equipment to be used in conducting the activities and programs at Camp MusArt. I also have been given the opportunity to discuss and have discussed with program organizers or staff any potential hazards and risks that may be associated with the activities and take full responsibility for doing so for myself and for the Child. I understand and acknowledge Camp MusArt LLC does not provide transportation to or from activities. I also understand and acknowledge that Camp MusArt LLC does not provide health, medical, accident, or any other insurance for the Child while enrolled and/or participating in Camp MusArt LLC programs or activities.
Jun 05, 2023
Parent or Legal Guardian for Name of Camper / Student:
Jun 05, 2023
Period / Term covered by this Waiver and Release:
Photo/Video policy: I hereby grant my permission to allow the use of voice, video, image, or likeness of my child to be
taken without identifying information to be used by the Camp MusArt for promoting their programs. The permission for
use of any of the media above is allowed for (check all that apply):
Tasting policy: Sometimes at Camp MusArt food is offered to the children occasionally, like tasting fruits or vegetables
grown in our garden or sharing a treat brought by another student or a teacher. We would like to request your permission to
allow your child eat the food offered at Camp MusArt. Please feel free to make comments below as necessary.
My child is
to have a snack, treat, or taste given by Camp MusArt. allowed
Initial My child is
to have their face painted. allowed
Video Watching: We occasionally play educational or G Rated programs for approximately 15 minutes each during snack
and lunch, and for 15 to 30 minutes during carpool and pre-recital time. My child is
to watch these programs. allowed
My signature below is evidence of my approval and acceptance of the terms of this waiver. I understand this waiver is in
effect until I provide, in writing, a cease order. I also agree to forego any right or entitlement I might have to any
compensation or fee. Finally, I agree that I am the legal guardian of the child named above.
Jun 05, 2023
I agree with the things stated in the liability waiver(s)