Summer Camp Registration

Jr. Rising Star

Grades K-2

Rising Star

Grades 3-12

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Will you need Before/After care for $10 p/hr?
How would you like to pay?

(Provide Payment AFTER hitting the SUBMIT button below)

Checks can be made out to

"Fort Wayne Youtheatre" and mailed to 

Fort Wayne Youtheatre

303 E. Main St.

Fort Wayne, IN 46802

Or payment can be made via phone at

260-422-6900.

We accept VISA or MASTERCARD.

WAIVER OF LIABILITY & PHOTO RELEASE FORM

 

  1. Waiver and Release of Liability. I acknowledge that serving as a student may involve a risk of personal injury (including fatal injuries) and property damage. I knowingly assume any and all risks associated with my student experience. I, for myself, my personal representatives and all others who might have a similar claim, hereby irrevocably and unconditionally FOREVER release, waive and discharge any and all charges, complaints, claims, liabilities, obligations, promises, agreements, controversies, damages, actions, suits, rights, demands, costs, losses, debts and expenses arising directly or indirectly from my volunteer experience (collectively, “Claims”) against Organization, Arts United or any of their respective affiliates, owners, predecessors, successors, assigns, agents, directors, officers, employees and representatives (the “Released Parties”). I understand that this Section 1 applies to all Claims of any nature whatsoever, whether known or unknown, suspected or unsuspected, foreseen or unforeseen.

 

  2. Photo Release. The Fort Wayne Youtheatre has my permission to use my or my child’s photograph/video publically for              any marketing or promotional materials. I understand that the images may be used in print publications, online                          publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation                shall become payable to me by reason of such use.

 

  3. Hold Harmless. I agree to DEFEND, indemnify and hold harmless any of the Released Parties from any and all losses,            damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs or                  expenses of whatever kind (including without limitation attorneys’ fees) that are incurred or suffered by any of the                      Released Parties (collectively, “Losses”) on account of any and all third party charges, complaints, actions, suits,                      demands and claims (collectively, “Third-Party Claims”) arising directly or indirectly from my failure to comply with the t              terms and conditions of this Agreement or my negligent act(s) or omission(s) or reckless or willful misconduct in                        connection with my volunteer services with Organization.

  4. Consent. Without limiting the foregoing, (a) in the event I sustain a personal injury as a result of my services as a                      student to Organization, I authorize all necessary medical treatment that may be prescribed by qualified medical                        personnel, and I agree that I will be solely responsible for payment of all costs arising from any such injury and medical            treatment; and (b) I consent to the use of my name and/or photograph or likeness by Organization without any                          compensation or inspection.

  5. General Provisions. (a) Any proposed amendment, discharge, termination or change to this Student Release and                      Waiver of Liability (“Release”) must be in writing and authorized by Organization in writing. (b) The waiver by                              Organization of a breach of any provision of this Release shall not operate or be construed as a waiver of any                            subsequent breach, and no waiver shall be valid unless it is in writing and is signed by the party against whom such                  waiver is sought. (c) I agree that this Release is intended to be as broad and inclusive as permitted by the laws of the                State of Indiana, and that this Release is to be construed in accordance with the laws of the State of Indiana, and any              dispute regarding the matters set forth herein shall be resolved in the federal or state courts sitting in Allen County,                    Indiana. (d) I expressly agree that if any provision of this Release is held invalid, that the balance of the Release shall,              notwithstanding, continue in full legal force. (e) I understand that the terms and conditions of the following provisions of            this Agreement will survive my completion of the volunteer experience with Organization: Sections 1, 3, 4 and 5.

Paypal

If paying via Paypal, please provide payment AFTER hitting the SUBMIT button above. 

Box Office:

260-422-4226

tickets.artstix.org

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303 E. Main St.

Fort Wayne, IN 46802

Youtheatre Office:

260-422-6900

info@fortwayneyoutheatre.org

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303 E. Main St.

Fort Wayne, IN 46802

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