(waiver-07-01-2016)

The undersigned(s) being the lawful parent(s) and/or guardian(s) of the above child, hereby consent to the participation by the child in all workshop, camp, and/or aftercare activities conducted by Firefly Expressive Arts and to the participation of the child in all events related to said activities.

The undersigned hereby further authorize(s) any of the staff, employees, agents and representatives of Firefly Expressive Arts to provide for, approve and authorize any health care at any hospital, emergency room, doctor’s office or other institution, employ any physicians, dentists, nurses or other person whose services may be needed for such health care, review and if necessary disclose the contents of any medical records, execute any consent form required by medical, dental or other health authorities incident to the provision of medical, surgical,or dental care to the child. Health care shall include, but not be limited to the administration of anesthesia, x-ray, examination, performance of operations, diagnostic and other procedures.

The undersigned(s) hereby further authorize(s) emergency transportation by either Firefly personnel or if necessary by ambulance or other emergency vehicle.

If there is no medical emergency, the Firefly staff will first use reasonable efforts to contact the parent(s) and /or guardian(s) before administering or authorizing any treatment.

Notwithstanding other provisions in this consent form, Firefly Expressive Arts shall not have the authority to withold or withdraw life-sustaining procedures for the child.

The facilities is well child-proofed and the children are consistantly well supervised. However, accidents do happen. The undersigned(s) assume(s) all risk of injury or harm to the child associated with participation in Firefly and agree(s) to release, indemnify, defend and forever discharge Firefly Expressive Arts and it’s staff, employees, and agents of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action in respect of death, injury, loss or damage to the child, or by the child, howsoever caused, arising or to arise by reason of or during the child’s participation at Firefly Expressive Arts.

(photo-waiver-11-11-2016)

This Photo Release Waiver makes it possible for Firefly to capture magical moments through out the day via photo and video media, and to share them with your family in private social media and newsletter formats. Firefly also uses the photo and video content to showcase the Firefly experience in the form of photos or short videos that are posted on our website and online presences, which may be viewable by the general public. Because Firefly's photographer is capturing Firefly activities "in the moment" it's not possible nor fair to remove children without photo waivers from the activity before taking a picture. Therefore ALL Firefly attendees must agree to this Photo Waiver.

With this understanding, I hereby give Firefly Expressive Arts the absolute right and permission to use photograph(s) of my children in its promotional materials and publicity efforts. I understand that the photograph(s) may be used in publication, print ad, direct-mail piece, electronic media (e.g. video, internet), or other form of promotion. I release Firefly Expressive Arts, the photographer, their offices, employees, agents and designees from liability for any violation of any personal or proprietary right I may have in connection with such use. Additionally, I will make no monetary or other claim against Firefly Expressive Arts for the use of photograph(s)/video(s). Firefly Expressive Arts does not share clients personal information with any other company or organization outside of Firefly.

(student-rec-release-12-09-16)

I hereby authorize Integrity Academy to release any information they have on file about my child, to Firefly Expressive Arts, LLC. with the express intent of ensuring Firefly has the information needed to best serve their role as an integrated, active, and informed participant in my child's support system during their time at Integrity Academy. This information will be held in the strictest confidentiality and Firefly shall not pass this information on to other third parties.