Summer Camp Participation Release Form Listen Summer Camps - 2020Participation and Media Release I am the parent or guardian of the student whose name appears below and I have authority to make legal decisions for the benefit of this child. I, on behalf of the child and for myself, waive any and all claims of liability arising from my child’s participation in this summer camp. I agree to defend, hold harmless, and indemnify Northwest Iowa Community College from and against any and all claims of liability that derive from claims that I or my child make against any other parties from this opportunity. Media: I agree to allow my child’s photograph, video tape or motion picture image that includes his/her name or likeness or any recording that includes his/her voice to be used in marketing materials to promote the Northwest Iowa Community College Intermediary Network program. I understand that my child’s photo/image will only be used in a positive manner in publications, print advertising, promotional materials or any other media to inform others about the career exploration activities coordinated by the Intermediary Network program and the school districts. * Required I, on behalf of the child and for myself, waive any and all claims of liability arising from my child’s participation in this summer camp. I agree to defend, hold harmless, and indemnify Northwest Iowa Community College from and against any and all claims of liability that derive from claims that I or my child make against any other parties from this opportunity. Media: I agree to allow my child’s photograph, video tape or motion picture image that includes his/her name or likeness or any recording that includes his/her voice to be used in marketing materials to promote the Northwest Iowa Community College Intermediary Network program. I understand that my child’s photo/image will only be used in a positive manner in publications, print advertising, promotional materials or any other media to inform others about the career exploration activities coordinated by the Intermediary Network program and the school districts. Yes -- I will allow my child’s image/comments to be used by Northwest Iowa Community College. No -- I will not allow my child’s image/comments to be used by Northwest Iowa Community College. Student Age * RequiredPlease enter a number from 0 to 21.Student Name * Required First Last Student Signature (for students 18 and older) * Required Reset signature Signature locked. Reset to sign again Parent Name * Required First Last Parent Signature * Required Reset signature Signature locked. Reset to sign again Date * Required MM slash DD slash YYYY CAPTCHA
