![]() ![]() We expect each participant to treat the instructor, volunteers, and fellow classmates with mutual respect and consideration.In order for your classes to be safe, fun, and enjoyable for all, we have some expectations we would like you to review before going to your first class. We expect our program to be the best of its kind. Expectations of a Participant, Parent/Guardian and Household Members * ![]() These consents will remain in effect for as long as the Student is participating in the Pablove Shutterbugs program. I hereby represent that the Student is of sufficient health to participate in Pablove Shutterbugs classes and that there are no medical restrictions that would prevent or limit the Student's participation. In all other (non-emergency) circumstances in which the Pablove Shutterbugs participant may need medical care while participating in the Pablove Shutterbugs program, I hereby consent to the provision of first-aid care to the participant as deemed appropriate and necessary until I can be contacted to consent to further treatment (if any is needed). In the event that Pablove organizes an in-person gathering of any type for and with the Students, and the Student's parent or guardian is not present, I authorize an agent of The Pablove Foundation to obtain emergency medical treatment for the Student as required, and release The Pablove Foundation from any Liability associated with such medical treatment. My physician, as well as his/her authorized representatives, is authorized to fill out, and provide to Pablove any forms that Pablove may require including forms relating to student's medical eligibility, the requested activity, and related medical considerations. The unidentified data will be kept by Pablove indefinitely. The purpose of the surveys is to assess the impact of the Shutterbugs classes, to measure quality of life impacts on our students through the Shutterbugs curriculum, and to support further research and program growth. Participation in surveys is voluntary and will in no way affect the student’s ability to participate in the program. Student information will be unidentified to ensure privacy and confidentiality. Data from these surveys will be reviewed and used in research-based program evaluation. In addition, the Student’s diagnosis code may be included in unidentified, confidential periodic survey instruments. I authorize and consent to the disclosure and use of the Student's medical diagnosis and other medical information to determine the Student's eligibility and any limitations or restrictions to participation in the Shutterbugs program. RELEASORS FURTHER AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS PABLOVE RELEASEES FROM ALL LIABILITY. The "Pablove Releasees" are (a) The Pablove Foundation (“Pablove”), and its employees, directors, officers, volunteers, and any and all agents of the Pablove Shutterbugs program, (b) any medical institutions affiliated or assisting in any way the Pablove Foundation, and (c) all third parties affiliated or assisting the Pablove Foundation and/or the Pablove Shutterbugs program in any way. "Liability" includes all claims, demands and causes of action of any kind and all damages of any kind (including attorneys’ fees and costs), including but not limited to death, personal injury, property damage, or other loss, whether arising out of negligence, strict liability, or carelessness on the part of the Pablove Releasees or any other person or entity. In consideration of the Student being permitted to participate in the Pablove Shutterbugs program, I, as parent or legal guardian on behalf of myself and the Student, or Student, individually (Releasors) hereby waive, release, discharge (i.e., give up), and covenant not to sue the Pablove Releasees for any Liability that may arise at any time relating to the Student's participation in the Pablove Shutterbugs classes or the Pablove Shutterbugs program. The student listed on this application has my permission to participate in the Pablove Shutterbugs program. ![]()
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