Vallejo Clay Camper Health & Safety Form

CAMPER (First and Last Name)

CAMPERS Preferred Pronouns

CAMPERS Age

My camper is going the Exchange for afternoon camp.

Yes

First name (Parent/Guardian)

Last name (Parent/Guardian)

Email (Parent/Guardian)

Relationship to child

Phone

Address

Emergency Contacts: (at least 2) Name/ phone/ relationship

Allergies

Medical Concerns

Any inhalers, epipens, etc. Please Specify.

Pick Up Policy

Camp starts at 9 am, ends at 12:00 pm. Campers who are not enrolling in The Exchange's afternoon program must pick up their camper by 12:00pm. Please do not be late. Campers will not be released without a parent/guardian appearing at the check-out table with their ID. Anyone picking up your camper must be on the AUTHORIZED PICK UP list for your camper. If a camper is picked up after 12:10 pm, the family will be charged a late fee of $1.00 per minute late. Please understand that the studio may have other classes or commitments that they must attend to. Multiple latenesses may result in removal from the camp without refund.

I understand and agree to the Vallejo Clay pick up policy

NAME(s) of PICK-UP Parent/ Guardian camper can be released to at pick up. (also authorized Pick Up - Bring ID)

Relationship

Phone

Liability Waiver

I, the undersigned individual (the “Parent/Guardian”), choose to allow (“campers name”) to enter and participate in permissible activities at 304/306 Georgia Street (“Vallejo Clay Workshop”).

Release

By signing this document, I release Licensor, its owners, staff, employees, volunteers,associates (collectively referred to in this document as the “Vallejo Clay Workshop”) from any liability or claim that I or my representatives may have against the Vallejo Clay Workshop with respect to any bodily injury, personal injury, illness, death, or property loss or damage that may result from my participation at Vallejo Clay Workshop space.

I voluntarily release and forever discharge and hold harmless theVallejo Clay Workshop from any and all claims or demands for damages, loss of services, costs and expenses, injuries, attorney fees, and any other call for reparation from any and all injury to me or my property arising in any way from my participation in a Session (as defined in the associated Space License Agreement) or other use of Vallejo Clay Workshop equipment or facilities, and any activities associated with the Vallejo Clay Workshop.

Risks

I understand that there may be risks of physical injury associated with handling certain pottery equipment and use of the Vallejo Clay Workshop, generally. Understanding these risks and the potential for others not listed, I agree to personally accept and assume all of the risks present in my child's use of the Vallejo Clay Workshop. My child's participation at Vallejo Clay Workshop is entirely voluntary, and I choose to participate in spite of the risks.

Miscellaneous

While in the Vallejo Clay Workshop, I agree to abide by any rules, codes, and policies that are put in place by the Vallejo Clay Workshop before or at any time during my and my child's participation. If I have questions or concerns regarding any policies or decisions made by any representative of the Vallejo Clay Workshop, I agree to bring them promptly and specifically to the attention of the staff members.

If I file a lawsuit against theVallejo Clay Workshop I agree to do so solely in the state of California and agree that the substantive law of California shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement isfound to be void or unenforceable, the remaining document shall remain in full force and

effect.

THE UNDERSIGNED PARTICIPANT ACKNOWLEDGES THAT THEY HAVE CAREFULLY READ THIS AGREEMENT, UNDERSTANDS ITS CONTENTS, AND UNDERSTANDS THAT THIS AGREEMENT INCLUDES AN ASSUMPTION OF THE RISK OF THE VALLEJO CLAY WORKSHOP ENTITIES’ NEGLIGENCE AND A RELEASE OF THEIR LIABILITY.

USER ACKNOWLEDGES THAT VALLEJO CLAY WORKSHOP ENTITIES ARE MATERIALLY RELYING ON THIS WAIVER AND IN ALLOWING PARTICIPANT TO ENTER AND PARTICIPATE IN VALLEJO CLAY WORKSHOP SESSIONS OR RELATED ACTIVITIES.

Liability Waiver Agreement: I understand and accept the rules and regulations described above.

Pick Up ID*

All Parents/Authorized Pick-Up people will pick-up on time, and Show ID prior in order for child to be released. Late pick up will result in late fees as described above

Print Name / Date

Photography release

My camper may be photographed for the purpose of promoting Vallejo Clay's children's programming.

I do not consent to my camper being photographed.

Pottery classes in beautiful downtown Vallejo

Pottery pickup hours

Vallejo Clay Camper Health & Safety Form

Pick Up Policy

Liability Waiver

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Vallejo Clay Camper Health & Safety Form

Pick Up Policy

Liability Waiver

SUBSCRIBE Sign up with your email address to stay informed about new classes, workshops, and events. We respect your privacy and do not share our email list.

SUBSCRIBE
Sign up with your email address to stay informed about new classes, workshops, and events.
We respect your privacy and do not share our email list.