Cedar County Theatre
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Cedar County Theatre
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Print this page We, the undersigned, as a parent or guardian, state that we are the only person(s) who have legal custody concerning the child named below. We acknowledge that there are inherent risks of physical injury involved with participation in the Missoula Children's Theatre production of "Rumpelstiltskin" in the year 2005, and we, the undersigned, hereby voluntarily assume those risks. Further, the undersigned in consideration for the child named below being allowed to participate in said production, do hereby fully release and discharge all persons and entities connected in any way with said program including but not limited to all instructors, all sponsors, Hartington Public School, Cedar County Theatre and Missoula Children's Theatre and volunteers from any and all claims, demands actions or caused action whatsoever, including but not limited to, loss of services, medical and other expenses arising out of any accident or physical injury to said child. This release is intended to cover both known and unknown results of any accident and injuries including further development thereof. Furthermore, in consideration of the foregoing, the undersigned to hereby expressly agree to indemnify and hold harmless all of the party's demands or action, which may be made or brought by, or on behalf of, said minor on account of any accident or injury. Dated this _____ day of ________________________, 2005. Name of Child_____________________________ Upcoming Grade_____ Male/Female____ Address________________________________ City__________________ ZIP____________ School_____________________________________ I have reviewed and understand the above release. Parent(s)/Guardian(s) signature(s)_____________________________________________________ Parent/Guardian contact phone ___________________________ For questions contact: Sheila Olsen, Project Coordinator, at (402) 254-3856 or sheilao@hartel.net For more information regarding Missoula Children's Theatre, please contact: Missoula Children's Theatre, 200 North Adams, Missoula, MT 59802 - (406) 728-1911 - www.mctinc.org - tour@mctinc.org
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Stage Fundraising // Search our Site // Program Sponsors // CCT Chat Cedar County Theatre * P.O. Box 752 * Hartington, NE 68739 Email us at cedarcountytheatre@hotmail.com Page Last Updated: 11/15/2005 04:36 PM |
