RELEASE FORM

Please complete the release form below for the class with Studio Playground on Saturday October 25 and Sunday October 26, 2025 at Boston Center for the Arts, located at 527 Tremont Street, Boston, MA, 02116.

All students must have a signed release form to participate.

STUDENT INFORMATION

Name

First Name

Last Name

Date of Birth

YYYY

Emergency Contact Name and Phone Number

Waiver

Please Electronically Sign to Accept the Liability Waiver and Audio/Video Release for Please complete the registration and release forms below for the class with Studio Playground on Saturday October 25 and Sunday October 26, 2025 at Boston Center for the Arts, located at 527 Tremont Street, Boston, MA, 02116.

LIABILITY & PROCEDURES WAIVER Class with Studio Playground on Monday October 21, 2024 at Boston Center for the Arts located at 527 Tremont Street, Boston, MA, 02116. Release of Liability • I will decline to participate in any activity that would put my well-being at risk due to a pre-existing condition. • I consent to participate in class activities (including running, jumping, warm-up and physical acting). I understand there are inherent risks in such physical activities, and I assume all risk of injury that may occur. • I do hereby waive, release, and forever discharge any and all rights and claims for damages which I have or which may hereafter accrue to me against Studio Playground, its affiliates, and their respective officers, directors, trustees, members, employees, and lessors, whether caused by negligence or otherwise. • I understand that by registering for the class, I have bought a place in the class and that all payments are non-refundable. • I agree to participate without engaging in behavior that is disruptive, disrespectful, demeaning, violent or abusive. I understand that I may be dismissed by Studio Playground in its sole discretion because of such behavior as assessed by the instructor(s) of the class. AUDIO AND VIDEO RELEASE • Participation in the Workshop acknowledges agreement that Studio Playground may record and store still photography, video and audio of participants. Studio Playground will own the recordings, including photographs, digital images and audio/video recordings and all rights related to them and agrees not to share the recordings/photographs with third parties unless required by law. The recordings/photographs may be used in any manner or media, such as promotions, publications, social media, and the Studio Playground website. • I acknowledge that I understand the content of this document and agree to the above terms. I am aware it is legally binding, and I sign it out of my own free will. By signing below, I acknowledge that I have thoroughly read, understand, and agree to these conditions, and I understand Studio Playground is released from liability for any damages or injury resulting from my participation in the class with Studio Playground on Saturday October 25 and Sunday October 26, 2025 at Boston Center for the Arts, located at 527 Tremont Street, Boston, MA, 02116.

First Name

Last Name

Date

YYYY