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The undersigned being the client and/or the lawful parent/guardian hereby consent to the participation by the client and/or child in all activities conducted by April Katz and the AIROW PROJECT coaches, its staff, volunteers, and agents to the participation of the client and/or child in all events related to said activities. The undersigned grants permission to April L. Katz and the AIROW PROJECT Coaches, its staff, volunteers, and agents to use photos and videos of or quotes from the client and/or child in print or electronic media including social media. The undersigned hereby further authorizes April L. Katz, any of the staff, employees, agents and representatives of The AIROW PROJECT to provide for, approve and authorize any emergency transportation by personnel or if necessary, by ambulance or other emergency vehicle, health care at any hospital, emergency room, doctor’s office or other institution or other persons whose services may be needed for such health care, review and if necessary, disclose the contents of any medical records, execute any consent form required by medical, dental or other health authorities incident to the provision of medical, surgical, or dental care to the client and/or child. Health care shall include, but not be limited to the administration of anesthesia, x-ray, examination, performance of operations, diagnostic and other procedures. The client and/or child are well supervised. However, accidents do happen. The undersigned assumes all risk of injury or harm to the client and/or child associated with participation in the program and agrees to release, indemnify, defend and forever discharge April L. Katz and The AIROW PROJECT coaches, its staff, employees, and agents of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action in respect of death, injury, loss or damage to the client and/or child, or by the client and/or child, howsoever caused, arising or to arise by reason of or during the client’s and/or child’s participation in the program.

Signature of Client and/or Parent/Guardian (if client is under 18yrs of age):

Date: May 20, 2024 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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