Please read, initial, and sign the form below. Or you may print this form HERE.

PARTY DATE

1. Voluntary Participation. I, the undersigned (“Participant”), as the parent or legal guardian of the minor child listed on this application (“Stated Minor”), acknowledge that I have voluntarily applied for the child to participate in the beading party, camp(s), and/or workshop(s) (“Activities”) by Dragonfly Designs, LLC (“Dragonfly Designs”) at the premises of the designated party host (“Party Host”), or at the premises of Dragonfly Designs, located at [address].

 2. Party Host Indemnification Clause (if applicable). Under the performance of this Agreement, the undersigned Party Host shall indemnify, hold harmless, and defend Dragonfly Designs, their respective employees, agents or administrators, successors, and assigns, from any and all claims, demands, causes of action, damages, costs, or liabilities, in law or in equity, of every kind and nature whatsoever, indirectly or directly resulting or caused by Dragonfly Design Activities. In the event a Participant fails to sign this Agreement, Party Host is bound by this clause, and shall reimburse Dragonfly Designs for any and all expenses incurred in connection therewith; provided that, Party Host has adequate notice of such action and an opportunity to defend.

Dragonfly Designs shall not be indemnified under this Section for liability or loss resulting from its own gross negligence or willful misconduct.

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3. Assumption of Risk. I AM AWARE THAT PARTICIPATING IN BEADING AND/OR CAMP ACTIVITIES MAY BE HAZARDOUS DUE TO POSSIBLE INGESTION, INJURY OR ANY OTHER FORESEEABLE OR UNFORESEEABLE RISKS TO THE STATED MINOR, MYSELF AND/OR MY PROPERTY. I VOLUNTARILY AUTHORIZE THE STATED MINOR’S PARTICIPATION IN THESE ACTIVITIES WITH FULL KNOWLEDGE OF THE POTENTIAL DANGERS INVOLVED.

I HEREBY AGREE TO ACCEPT ANY AND ALL RISKS INCLUDING BUT NOT LIMITED TO PERSONAL OR REAL PROPERTY DAMAGE, INJURY OR DEATH OF STATED MINOR, AND VERIFY THIS STATEMENT.

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4. Release of Liability. As consideration for being permitted by Dragonfly Designs to participate in these activities, use related facilities and beading equipment, I hereby agree that I, my assignees, heirs, distributees, guardians, and legal representatives will not make a claim against, sue, or attach the property of Dragonfly Designs on account of any personal or real property loss or damage, nor any claims or demands therefor on account of injury to the person or death of Stated Minor. The is true whether such damage is caused by the negligence of employees, agents, relatives, third party contractors (collectively “Employees”) of Dragonfly Designs while the Stated Minor is in, upon, or about any premises under Dragonfly Design’s control. This includes, but is not limited to, all liability for damages or injury resulting from the active or passive negligence of Dragonfly Designs and Employees while the Stated Minor is under its care. I hereby release, discharge, and agree to indemnify Dragonfly Designs from all actions, claims, damages, costs or demands that I, my assignees, heirs, distributees, guardians, and legal representatives now have or may have for any of the loss or damage mentioned above arising or resulting directly or indirectly from the Minor’s participation in the activity.

5. Personnel Policies. To the extent that Dragonfly Designs deems necessary, a safety talk about the proper handling of equipment will be given prior to beginning the activity. Employees will reasonably supervise participants during the contracted activity duration. It is further warranted that such participation and use of any equipment constitutes an acknowledgment that such beading equipment and activity tools thereon have been inspected and that said equipment is being safe and reasonably suited for such intended use. The primary concern of Dragonfly Designs is personal safety and the capability of all children under its care to be able to control one’s body.

Understanding this, I state to the best of my knowledge, the Stated Minor has no medical, physical, mental, or emotional health conditions that would hinder his/her participation in Activities.

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6. Medical Permission Authorization. In the event of a medical emergency, while Stated Minor is under Dragonfly Design’s care, Dragonfly Designs will attempt to notify the contracted Primary Contact by telephone. If the Primary Contact cannot be reached immediately, the listed Emergency Contact will be telephoned. If applicable, additional medical authorization agreements are incorporated by reference and shall be controlling in the event of a conflict.

7. PERSONAL IMAGE AND VIDEO RELEASE. As a Participant, I hereby give my consent for Dragonfly Designs to use either my, or the Stated Minor’s photograph, silhouette, likeness, recorded voice, performances, poses, acts, and appearances in its publications. This use includes but is not limited to Dragonfly Design’s website, advertisement video, unlimited distribution and any other reproduction. Dragonfly Designs promises to not identify children in any way.

Accordingly, I agree that I will not assert or maintain against Dragonfly Designs, its successors, assigns and licensees, any claim, action, suit or demand of any kind or nature whatsoever, including but not limited to, those grounded upon invasion of privacy, rights of publicity, expectation of confidentiality, copyright ownership and/or other civil rights, or for any other reason in connection with the authorized use of the undersigned physical likeness and sound as herein provided. 

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If you do not want the Stated Minor’s picture taken and published please feel free to opt-out by checking this box

 8. Knowing and Voluntary Execution. I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN DRAGONFLY DESIGNS AND ME AND I SIGN IT AT MY OWN FREE WILL.

Executed      in , California.
by on behalf of


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MAILING LIST

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