Education Workshop Communication

Education Workshop Communication

Organization Name:    Workshop Title:

Workshop Date(s):    Start Time:    End Time:

Student Information

Parent / Guardian or Adult Participant

Workshop Logistics & Fees

Payment Arrangements:
Full payment prior to start Installment plan (as arranged) Scholarship/waiver applied

Transportation & Attendance

I authorize the Organization to provide supervised transportation to/from the workshop location when applicable:
Yes No

Emergency & Medical Information

Current Medications (name, dosage, administration instructions):

I consent to emergency medical treatment for the participant if, in the judgment of the Organization or designated health personnel, such treatment is necessary:
Yes No

Media, Communications & Privacy

Media Release: I authorize the Organization to photograph and/or record the participant during the workshop for educational, promotional, and archival purposes. I understand that such media may be used in print, electronic, and social media materials:
Yes No

Communication Preferences (check all that apply):
Email SMS / Text Phone Call

Policies, Acknowledgments & Release

Agreement to Participate — Acknowledgment of Risk: I acknowledge that participation in the workshop involves inherent risks, which may include but are not limited to personal injury, property damage, or illness. I voluntarily assume all such risks on behalf of the participant.

Release and Indemnity: To the fullest extent permitted by law, I, on behalf of myself and the participant, hereby release, waive, discharge, and covenant not to sue the Organization, its trustees, officers, employees, volunteers, and agents (collectively, Released Parties) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained while participating in the workshop. I also agree to indemnify, defend, and hold harmless the Released Parties from any loss, liability, damage, or cost, including reasonable attorneys' fees, arising out of or related to the participant's actions or omissions.

Code of Conduct and Discipline: The participant agrees to comply with all rules, safety instructions, and directions issued by workshop staff. The Organization reserves the right to dismiss any participant whose conduct endangers others or disrupts program delivery; dismissal may occur without refund.

Cancellation and Refunds: Unless otherwise specified by the Organization, full refunds are provided only when cancellation is received at least 14 days prior to the first scheduled workshop date. Refunds for medical or emergency reasons will be considered upon written request and receipt of documentation.

Data Use and Confidentiality: The Organization will maintain participant records for administrative purposes. Basic participant information and emergency contact details may be shared with contractors or health providers on a need-to-know basis to ensure participant safety. The Organization will not sell or otherwise disclose personally identifiable information for commercial purposes.

Certification: By signing below I certify that I have legal authority to act for the participant named in this form. If signing as a parent or guardian, I represent that I am the parent or legal guardian of the participant. If the participant is 18 years of age or older and I am the participant, I represent that I am legally an adult and authorized to sign on my own behalf.

Additional Notes

Sign Now