Educational Seminar Packet

EDUCATIONAL SEMINAR PACKET

Seminar Information

Seminar Title:

Date:    Start Time:    End Time:

Location:

Coordinating Staff:    Contact Phone:

Participant Information

Participant is a minor: (check if under 18)

Emergency Contact

Medical Information & Authorization

Allergies (list):

Current Medications / Medical Conditions (include restrictions):

I authorize staff to administer routine first aid and over-the-counter medication as needed:

In a medical emergency, I consent to emergency medical treatment if the parent/guardian or emergency contact cannot be reached:

Media Release

I grant permission for photographs, video, and audio recordings taken during the seminar to be used for educational, promotional, or archival purposes by the program administrators. I understand no compensation will be provided.

Consent to media use: Yes   No

Code of Conduct & Attendance

Participants are required to follow the standards of conduct established by the hosting organization. Prohibited conduct includes discrimination, harassment, disruptive behavior, and failure to follow safety instructions. Repeated or serious violations may result in removal from the seminar without refund.

I have read and agree to comply with the Code of Conduct and understand that failure to comply may result in removal:

Fees, Cancellation, and Payment

Registration Fee: $

Payment Method: Card    Check    Cash

Cancellation & Refund Policy: Requests for cancellation must be submitted in writing. A partial refund may be issued at the program administrator's discretion; non-attendance without timely cancellation does not entitle participant to a refund.

I agree to the stated fee and cancellation policy:

Liability, Assumption of Risk, and Indemnity

By signing below, the signer acknowledges and agrees that participation in the seminar may involve inherent risks, including but not limited to personal injury or property damage. The signer hereby assumes all such risks and releases, waives, discharges, and covenants not to sue the hosting organization, its officers, employees, volunteers, and agents (collectively, Released Parties) for any liability, claim, loss, or expense arising from participation, except to the extent caused by the gross negligence or willful misconduct of the Released Parties.

The signer further agrees to indemnify and hold harmless the Released Parties from any third-party claims, demands, or liabilities arising out of the signer's acts or omissions during the seminar, including reasonable costs of investigation and defense.

I have read, understand, and accept the Liability, Assumption of Risk, and Indemnity provisions above:

Data Use & Privacy

Participant contact information and program participation records will be maintained for administrative and educational purposes. Records will be handled in accordance with applicable privacy standards. I consent to the use of my contact information to receive seminar-related communications.

Consent to receive electronic communications:

Parent / Guardian Information (Required if Participant is a Minor)

As the parent or legal guardian of the minor named above, I authorize the minor's participation in the seminar and agree to the medical authorization, media release, code of conduct, fee terms, and liability provisions in this packet:

Acknowledgment

By signing below, the signer certifies that the information provided in this packet is true and accurate to the best of their knowledge, that they have authority to sign (as participant or parent/guardian), and that they accept and understand all terms, policies, and releases contained herein.

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