Participant *
Responsible Guardian *
Responsible Guardian
I hereby grant my permission for my child to attend field trips with ELEVATE. If the field trip is at a location requiring transportation, I grant Two Wins, permission to approve such transportation back and forth between UNT Dallas and location of the trip.
In consideration of my child(ren)’s participation at ELEVATE, and without any further consideration from Two Wins Organization, I hereby grant permission to Two Wins, staff and affiliates to utilize my appearance, performance or voice in any and all manner and media for the strict purpose of promotion, reporting or publication. ELEVATE and Two Wins may use my child(ren)’s name, likeness, voice and biographical material in connection with publication, promotion, exhibition and distribution of such material. I understand that no royalty, fee or any other compensation of any kind shall become payable to me by reason of such release and use of any photograph.
I acknowledge that the possession or use of alcoholic beverages and illegal drugs are strictly forbidden. I understand the possession of any weapon (firearm, knife, explosives, etc.) is strictly forbidden on University of North Texas Dallas campus. Because I acknowledge the risks of allowing my child(ren) to participate, I agree to release and hold harmless Two Wins and its founder, trustees, directors, officers, employees, agents, affiliates, volunteers and medical staff (“Staff”) from any and all injury claims of any other nature which may result from my child(ren)’s participation at and travel to or from ELEVATE. I agree to indemnify and hold Two Wins, its Staff and other children at ELEVATE harmless from any and all liability caused by my child(ren), whether or not intentional. *
Emergency Contact *
Emergency Contact