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CENTER FOR SNAKE CONSERVATION DBA MY NATURE LAB RELEASE AND WAIVER OF LIABILITY

My Nature Lab

Open Lab Waiver and Release

This waiver applies to me as the adult participant and, if applicable, to any child(ren)/minor(s) I list on this form. If under 18, this form must be signed by a parent or legal guardian.

Assumption of Risk

My Nature Lab is a hands-on learning environment. Participants may handle live, non-venomous animals, including but not limited to reptiles, amphibians, insects, and worms. Handling animals carries inherent risks such as minor bites, scratches, allergic reactions, or exposure to animal waste. I understand and accept these risks for myself and, if applicable, for any listed child(ren)/minor(s).

Release of Liability

In consideration of participating in Open Lab, I release and hold harmless My Nature Lab, its staff, and volunteers from any liability for injury, illness, or property damage that may occur during participation.

Medical Consent

In case of emergency, I authorize My Nature Lab staff, volunteers, or emergency personnel to provide or seek medical treatment for myself and/or any listed child(ren)/minor(s). I agree to be financially responsible for any resulting expenses.

Photography Release

I understand that photos or videos taken at Open Lab may be used by My Nature Lab for educational or promotional purposes without compensation.

First Participant's Name
First Name*
Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.

A parent or court-appointed legal guardian must sign for any participant under 18 years of age and agrees that both they and any listed minor(s) are subject to all terms of this document.




Parent or Guardian's Name
First Name*
Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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