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Learn
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Opportunities
Schacht Gallery
Contact
SHOP
Youth Emergency Contact Information & Release Form
Child's Name
*
First Name
Last Name
Parent 1 Name
*
First Name
Last Name
Parent 1 Cell Number
(###)
###
####
Parent 1 Email
*
Parent 2 Name
First Name
Last Name
Parent 2 Cell Number
(###)
###
####
Parent 2 Email
Home or other Preferred Phone
(###)
###
####
Family Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Contact Name & Phone #
*
Family Doctor Name & Phone #
*
Authorized Pick Up Person(s)
*
Does SCAC have permission to photograph your child? Images might be used in social media or on our website.
*
Yes
No
Any health issues we should be aware of?
Please read and approve your understanding of our Emergency Medical Care - Permission/Release:
*
In the event of a perceived emergency injury or illness to my child while attending Saratoga Clay Arts Center, LLC programs, I hereby authorize Saratoga Clay Arts Center, LLC to consent to medical treatment on behalf of my child. By accepting below, as parent or legal guardian of the child identified on this form, I hereby authorize Saratoga Clay Arts Center, LLC and its adult officers, employees and agents into whose care the registered child has been entrusted, to consent to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital care to be rendered to said minor under the general or special supervision and upon the advice of a licensed physician or surgeon. To also disclose any personal medical information regarding said minor to medical professionals. It is understood that if time and circumstances reasonably permit, Saratoga Clay Arts Center, LLC will endeavor, but is not required, to communicate with the parent or guardian prior to consenting to such treatment. The undersigned further agrees to RELEASE, WAIVE, DISCHARGE AND COVENANTS NOT TO SUE EITHER Saratoga Clay Arts Center, LLC, its employees, officers and agents on behalf of the undersigned, the registered minor and their personal representatives, assigns, heirs, and next of kin for any loss, damage, or claim therefore on account of any injury to the minor associated with any medical care performed or provided with consent given pursuant to this authorization. This authorization to consent to treatment of the minor identified above is given to Saratoga Clay Arts Center, LLC in conjunction with any activity or event in which the minor’s care is entrusted to Saratoga Clay Arts Center, LLC. It is understood that in the event that this Agreement is accepted to by one parent or guardian, the parent or guardian acknowledges that he/she is also acting as agent of the other parent/guardian with authority to accept this Agreement on his or her behalf. * I have read and accept Saratoga Clay Arts Center's Emergency Medical Care - Permission/Release
I accept
Please read and approve your understanding and acceptance of the "Fine Print"
*
1.ENROLLMENT: Children will be enrolled in sessions on a first-come, first-served basis. Enrollment above or below the recommended age level for morning and afternoon sessions will be considered in special cases. 2. ABSENCES: There are no makeup days for absences or for days missed and parents are financially responsible for all days that their child has registered to attend. There will be no prorating of tuition for missed days due to sickness or travel, or any other reason. 3. TUITION: Full tuition must be received in order for your child to be registered for workshops. There is a $10 fee on all returned checks. For half-day programs, $40.00 of each session’s tuition is non-refundable. For each of our half-day sessions, a full refund less $80.00 will be issued if you cancel at least one month prior to the start of your child’s session. No refund will be granted for any reason if you cancel within one month of your child’s session, no exceptions! Tuition is not transferable from session to session or for classes missed. 4. SESSION CHANGES/OTHER CHARGES: Session changes will be made on a space available basis at the directors discretion. 5. SESSION CANCELLATIONS: We reserve the right to limit class size, substitute instructors or cancel sessions for which there are not enough children enrolled. Every effort will be made to place your child into another session offered. 6. WITHDRAWALS AND REFUNDS: We do not offer refunds for camper's time off, missed days, family vacation, partially missed days, any medical reasons or anything else that requires time off from camp. We do not credit tuition for missed classes. If notified 24 hours in advance, and if space is available, students can make up one class per week on another day. If a student is asked to withdraw from class, no refund will be given. While Saratoga Clay Arts Center, LLC summer programs strives to make Camp enjoyable for all campers, satisfaction with the experience is subjective on the part of the child and the parent. Therefore, it is understood and agreed that Saratoga Clay Arts Center, LLC summer programs cannot and does not guarantee or warrant any campers' satisfaction. It is also understood and agreed that there are no other agreements, expressed or implied, between Saratoga Clay Arts Center, LLC summer programs and me or my child regarding Saratoga Clay Arts Center, LLC summer programs or activities. 7. YOU FURTHER AGREE AND UNDERSTAND: A. Allow you child's image to be used in any and all promotional photographs, videos or websites and print ads. B. To not hold Saratoga Clay Arts Center, LLC summer programs responsible for any articles of clothing or personal belongings that are lost or damaged by theft, fire, natural disaster or other occurrence. * I have read and accept Saratoga Clay Arts Center's "Fine Print"
I accept
Please read and approve your understanding and acceptance of our Parent/Guardian Release Form
*
1. ACCEPTING BELOW HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE Saratoga Clay Arts Center, LLC, its employees, offices, and agents (all hereinafter referred to as “releasees”) from all liability to the undersigned, his or her personal representatives, assigns, heirs, and next of kin for any loss, damage, or claim therefore on account of injury to the person or property of the undersigned, whether caused by any negligent act or omission of the releasees or otherwise while the undersigned is participating in any Saratoga Clay Arts Center, LLC activity including but not limited to using any facilities or equipment in connection with the activity. 2. ACCEPTING BELOW HEREBY AGREES TO INDEMNIFY AND HOLD HARMLESS releasees from all liability, claims, demands, causes of action, charges, expenses, and attorney fees (including attorney fees to establish the releasees right to indemnity or incurred on appeal) resulting from involvement in this activity whether caused by any negligent act or omission of the releasees or otherwise. 3. ACCEPTING BELOW HEREBY ASSUMES FULL RESPONSIBILITY FOR RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE while upon property utilized by the releasees or participating in the activity or using any facilities and equipment utilized by the releasees whether caused by any negligent act or omission of releasees or otherwise. ACCEPTING BELOW EXPRESSLY AGREES that the foregoing release and waiver, indemnity agreement and assumption of risk are intended to be as broad and inclusive as permitted by New York law and that if any portion thereof be held invalid, notwithstanding, the balance shall continue in full legal force and effect. 4. I ACKNOWLEDGE THAT I HAVE READ THE FOREGOING and that I am aware of the legal consequences of this agreement, including that it prevents me from suing Saratoga Clay Arts Center, LLC, its employees, offices, and agents if my child is injured or damaged for any reason as a result of their participation in this activity. I further acknowledge that no oral representations, statements or inducements have been made. 5. IT IS UNDERSTOOD THAT THIS CONTRACT CONSTITUTES THE FULL UNDERSTANDING of the parties hereto and no change, modification or waiver of any of the terms shall be effective unless in writing and signed by both parties. * I am the Custodial Parent or Legal Guardian of the minor child and have read and accept the terms and conditions of this agreement. I also accept the terms and conditions of this Agreement on behalf of the minor child. In addition, I am also acting as agent of the other Parent/Guardian and have full authority to enroll the child in camp and to accept the terms and conditions of this Agreement on his/her behalf.
I accept
Saratoga Clay Arts Center affirms and abides by the same standards as listed in said protocols and has expanded sanitation procedures accordingly. By signing my name below, I release the center and the business from any and all liability for unintentional exposure or harm due to Covid-19.
Thank you!