PROGRAM RELEASE FORM

    I acknowledge that in the event of an emergency Vision Education & Media personnel will attempt to contact me and/or the other emergency contact persons listed above for further instruction. If my child is injured and should require immediate emergency care, Vision Education & Media personnel are authorized and directed to contact emergency response personnel at 911 or if unavailable, transport the child to the nearest emergency care facility. Vision Education & Media shall have no further obligation. I hereby release Vision Education & Media, its personnel and agents from liability for any injuries sustained by my child, or for any injuries my child may sustain except arising form gross negligence of Vision Education & Media or its personnel.  I will not hold Vision Education & Media, its personnel and agents liable for the decision not to obtain emergency care for my child in the event that they should later be determined to have required immediate emergency care. Unless other instructions are, the above accurately reflects my desires with regard to the care of my child.   
    

    I understand and agree that I am hiring Vision Education & Media solely for the purposes of instruction of my child in activities related to Robotics. I acknowledge and understand that there exist potential risks of injury to my child in such activities. I agree to take full responsibility for any injury, harm or loss to the person or property of my child that they may suffer resulting from activities related to Robotics.  If any pre-existing condition might affect my child’s ability to be instructed in the activities related to Robotics and I have not indicated such above, I am solely responsible for any injury sustained by my child because of such condition.  I release Vision Education & Media, its Director, staff and all other Vision Education a& Media personnel and agents form any liability resulting from actions, and/or causes of action in any and all forms against them. This Acknowledgment and Waiver survives termination of the student/ instructor relationship between my child and Vision Education & Media and is governed by the laws of the State of New York.  I understand that signing this is the only evidence of my acceptance of the terms and conditions of this Acknowledgment and Waiver.

I declare that I am the LEGAL GUARDIAN of the named minor.

    

    WAIVER & RELEASE

Note: By completion of the Registration Form, the participant’s legal guardian affirms having read and agreed to the below.

Sponsoring Organization:  VISION EDUCATION & MEDIA, LLC (“VEM”) 

In consideration of my child’s involvement under the auspices of this sponsoring organization, and for other good and valuable consideration, the receipt of which is hereby acknowledged, I understand, acknowledge and agree that:

I will allow my child to participate in :
VEM’s RoboFun workshops, classes, after school, birthday parties and summer camps at 38 East 23rd Street, NY, NY 10010 and further:

    1. I knowingly and freely assume all such risk and full responsibility for my child’s transportation to and from VEM’s premises.

    2. I acknowledge and understand that my child will be engaged in activities that may involve risk of physical injury which may result not only from their own actions, inactions, or negligence, but the action, inaction or negligence of others.

    3. I hereby release, indemnify, forever discharge and hold harmless VEM, its affiliates, subsidiaries, directors, agents, officers, employees and students from any and all responsibility, loss or damage to person or property, liability, claims for personal injury, legal action or suits, damages or losses of any kind or description, both at law and in equity, arising out of, or in any way connected with my child’s participation in VEM classes or activities including all  RoboFun Summer Camp  classes  and any other classes(hereby referred to as "the Classes"), including, but not limited to, all travel or physical activities in any way relating to VEM activities and/or the Classes.
     
    4. I hereby agree and covenant myself, and my successor and assigns, never to sue, either at law or in equity, VEM, its affiliates, subsidiaries, directors, agents, officers, employees and students on account of any such claim, costs, demands, liability, damage, injury, or loss arising from, related to or in connection with

i. My child’s travels including to and from any locations while involved with the Classes,
ii. My child’s attendance and participation in VEM activities, including, without limitation, the Classes, and any and all physical activities undertaken by my child during the Classes, or
iii. My child’s participation in any activities during breaks between or in relation to the Classes, including physical activities during any travel to or at playtime in parks or anytime while under the supervision of VEM.               

IN WITNESS WHEREOF, I intend this document to be legally binding.

         

    BEHAVIOR POLICY 

If VEM determines that a child is unable to participate in class in an appropriate manner and/or is a safety risk to himself , other students or RoboFun staff, the child will be removed from the RoboFun classroom and require that his/her parent or caregiver immediately pick up the child.   

    MEDIA RELEASE 

Vision Education and Media may wish to use examples of various sorts of media for professional development, website and/ or in printed materials. This includes photos designed to show activities that are happening with projects and/or with activities related to robotics, video game design, animation, claymation, RoboFun Summer Camp and other RoboFun workshops held at 38 East 23rd Street.  Vision Education & Media carefully adheres to all federal, state and local laws that govern the use of digital media featuring minors, both to ensure our compliance and to protect your family’s rights, privacy and safety.  Student names will not be used.  

I understand that I shall not receive compensation, now or at any later date, for use of the images of my child.    

I do give my permission and release to permit my child to appear in any and all media (website, print, audio, etc.) and in advertising by Vision Education and Media.  


    ENROLLMENT AND PAYMENT POLICIES

Your child's’ enrollment in RoboFun is not guaranteed until full payment is received.

Deadline for enrollment is 3 weeks prior to workshop start date. Late enrollment will result in a $35 late charge. There is a returned check fee of $30. Deadline for cancellation is 3 weeks prior to workshop start date to receive a full refund. Refunds are not issued after this deadline.

Make-ups and refunds are not provided for missed classes; workshop costs are not pro-rated for missed days or partial day / week attendance.

Payments for birthday parties must be submitted 2 weeks prior to the date of the scheduled party.  If payment is not received, the date of the party is not reserved.