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Art AYIC Participant Release Waiver
Art AYIC 2026 Registration Waiver
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Participant Name
*
First
Last
Participant Personal Email
*
Email
Confirm Email
Participant Phone Number
*
Participant Age
*
Participant School Name
*
Art AYIC Ticket Order Number
*
If you have paid through your school’s online registry (E.g. SCO, School Day) as you are a part of a chapter, please state your school name.
Are you a part of a school chapter?
*
Yes
No
Parent/Guardian Name
*
First
Last
Parent/Guardian Email
*
Email
Confirm Email
Parent/Guardian Phone Number
*
Emergency Contact Name
*
First
Last
Emergency Contact Phone Number
*
Emergency Contact Email
*
Email
Confirm Email
Notice
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I understand that any external attendees/guests (not participating) can attend the conference, however, they must have a guest admissions ticket to their name and have filled out a waiver, both of which will be released later. I also acknowledge that all tickets are non-refundable.
Minors must get the boxes below ticked by their legal parent/guardian.
*
I am the legal parent/guardian of the participating minor. I have read and agree to the ACCIDENT WAIVER, RELEASE OF LIABILITY AND MEDIA RELEASE TERMS below. I understand that ticking this box will constitute as my legal signature.
ACCIDENT WAIVER, RELEASE OF LIABILITY AND MEDIA RELEASE FORM
Event: Art AYIC 2026
Art AYIC 2026 is a conference that will include hands-on workshops involving the use of various materials and equipment. Items such as food, prizes, etc., may be distributed. STEAM IC is only the event host and is not responsible for the participants’ transportation or any other necessities.
I AM THE LEGAL PARENT/GUARDIAN OF THE PARTICIPATING MINOR AND I HEREBY ASSUME ALL OF THE RISKS OF THE CHILD’S PARTICIPATION IN THIS EVENT, and waive, release and discharge STEAM IC, and their directors, board members, officers, employees, volunteers, agents, representatives or assigns and the event sponsors, from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my or the child’s death, disability, personal injury, property damage, property theft, or actions of any kind which may occur to them as a result of participation in the above-named event. I agree to indemnify, hold harmless, and promise not to sue the entities or persons mentioned above for any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of those released or otherwise.
This accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I authorize STEAM IC, its partners, agents, representatives, assigns, successors in interest and licensees, to photograph, audiotape, and/or videotape the child and grant the Organization and its partners the irrevocable right to use their photograph, audio recording, video recording, or any reproduction or modification thereof (the “Photograph,” “Audio,” and/or “Video”), in any manner or medium throughout the world an unlimited number of times in perpetuity in advertising, trade, promotion, exhibition, or any other lawful purpose.
I understand that I will not receive any monetary compensation for the permissions I am granting herein. I hereby waive any right of inspection of approval of the uses to which the Organization may put the Photograph, Audio, and/or Video.
I acknowledge the Organization will rely on this permission and hereby release and discharge the Organization from any and all claims and demands arising out of or in connection with the Photograph or the exercise of the permissions granted here, including any or all claims for libel, invasion of privacy, or emotional distress. I understand that I cannot withdraw my consent after I sign this form and that this consent and release is binding on me and my heirs, legal representatives and assigns.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND AGREE TO IT OF MY OWN FREE WILL.
Information Consent
My and/or my child’s name and email address may be shared with STEAM IC partners for promotional purposes
Submit