• If you are 18 or older, please sign the bottom of this form.
• If you are under 18 years of age, please have a parent or guardian sign the form.
NOTE: all students under the age of 10 must be accompanied by a parent/guardian.
(Name of Parent/Guardian)
give permission for
(Name of Student)
to attend JVL SUMMER SCHOOL FOR PERFORMING ARTS (JVL SSPA) on July 1-11, 2017 in YMCA Geneva Park, Orillia, Canada.
The JVL SSPA program may include public performances and permission is hereby given for the students to take part in such performances without compensation. The JVL SSPA may use photographs, statements, articles, names, music, art, films and videotapes of/by the students in promoting Summer School/Summer School related activities, publication, advertising, exhibitions and distribute such recordings in whole and part, without restrictions and limitations, for any educational or promotional purpose that JVL SSPA and those acting on their behalf deem appropriate. I agree that all rights in and to any and all recording made of student’s performances, including all video media audio media, film and photographs shall be owned exclusively by the JVL SSPA.
I understand and accept the measures that the JVL SSPA has taken to provide a program of high quality, and I accept that my child will be expected to behave accordingly. The curfew is in effect from 11.00 pm and all students MUST be in their rooms at this time. No visitors are allowed in rooms after 11.00 pm. Also, no overnight guests are allowed. Room-check is conducted nightly, and violations are reported immediately to the director. Students are not permitted to possess and/or consume illegal drugs and alcoholic beverages of any type. The JVL SSPA reserves the right to expel any student for violations of JVL SSPA policy without refunding any fees paid. If my child participates in behavior deemed unacceptable by JVL SSPA or causes any damages to equipment and/or rooms that will require repair and/or an excess cleanup I am willing to incur the expense of that repair and of my child’s transportation back home.
The JVL SSPA will contact Parent/Guardian in case of serious sickness or accident. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the JVL SSPA staff to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child named above. I also hereby give the JVL SSPA permission to administer medication deemed necessary by the physician selected. I understand that the JVL SSPA assumes no liability for injury and accidents that may happen to my child or his/her belongings while traveling to and from home or during our stay in YMCA Geneva Park, Orillia, Canada and also while traveling to and from performing venues and to and from excursion destinations.
I understand and agree that as a condition of the participants use of the facilities assigned to the JVL SSPA he/she assumes all risk of personal injury, death or property loss resulting from any cause whatsoever including but not limited to the inherent risks of the program, breach of contract or breach of statutory, duty of care or breach of the Occupier’s Liability Act on the part of JVL SSPA. The participant agrees that its employees and agents shall not be liable for any such personal injury, death or property loss which occurs outside the program parameters and releases JVL SSPA its employees and agents of all claims with respect thereto.
Name and signature of the student:
Name and signature of parent or guardian (if the student is under 18):