I hereby give permission for my child to be photographed, videotaped and/or interviewed for use by
ABADÁ-Capoeira Marin (ACM) in promotional materials.
I hereby give my consent to have my child treated by a physician or surgeon in case of sudden illness or injury while participating in an ACM program. It is understood that the cost thereof will be at my
expense. To protect the safety of staff and our members and reduce líability, ACM staff does not
dispense or store medication of any kind for our participants.
ACM will only supervise youth in the building during class times. I am solely responsible for my child's
transportation to and from ACM's studio location.
I hereby release (for myself, my executors and administrators) and WAIVE any and all rights to claims for damages arising from any illness, accident, or occurrence caused by or as a result of my child's
participation or connection with ACM, its instructors, agents, representatives, and/or facilities. ACM, its
agents, instructors, representatives, and facilities shall not be held responsible by me for the loss or theft of my child's belongings. I have been warned that my child must be in good health to participate in
this program and I now declare that my child is in good health. I declare that I have read and understood the foregoing statement and that I have either consulted a physician for my child or voluntarily chosen not to consult a physician before starting or during the course of this program.
Students are not supervised when they are not in class. They are responsible for their own safety and
their own belongings. Students must respect the space, ACM staff and students, and remain quiet and
respectful of any class that is in progress. There are no drugs, no alcohol or weapons of any kind allowed in the studio at any time. Any member who brings weapons, drugs, or alcohol into the studio or comes to the studio under the influence of drugs or alcohol will be removed from the program. ACM is a safe space. Anyone who violates or jeopardizes the safety of the facility will be removed from the program.
{name} has my permission to participate in any activities at ACM. She/he has been advised regarding ACM's rules and regulations, and we agree to comply with these policies.
{sign_date}
ABADÁ-CAPOEIRA MARIN
