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Childway Art Space

3020 Canton Rd
Marietta, GA 30066
Suite 222

office@childwayart.com
+19295449204

Weiver Form

PARENT’S AUTHORIZATION & WAIVER FORM: I give permission to Childway Art Space to use photos taken of my child’s artwork to be used for local news and marketing. I also give permission to Childway Art Space to use photos my child’s artwork to be used for marketing on social media, including Facebook, Instagram, and TikTok

ABILITY TO ENGAGE IN ART ACTIVITIES AND ASSUMPTION OF THE RISK:

Childway Art Space takes all possible precautions to reduce risk and provide safe, healthy and enjoyable experiences. I warrant that my child is able to follow directions for all activities in the studio/class. I acknowledge that risks from participation in class activities exist and that I have allowed my child to attend art class knowing these risks and their possible consequences including personal injury.

WAIVER AND RELEASE OF LIABILITY: As a parent or guardian of my child, I agree that I will not hold Childway Art Space liable for any personal injury, property damage or loss of insurance. I agree to release and hold harmless Childway Art Space and owner, Anna Robaczewska, from all liability incurred as a result of my child’s participation in studio class and that these terms serve as a release for me, volunteers, property owners and members of my family.

I am the parent/guardian of the child that I am registering for classes at Childway Art Space. 

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle 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.
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*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
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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