Youth Permission Form Logo
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  • English (US)
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  • Optional Demographic Information



  • Photo / Media Consent

    I understand my child's image may be taken by photograph or video while at the studio or other special events. I grant permission for heARTS to publish my or my child's photograph or likeness in promotional publications (print, digital, or video formats) and to the media to promote the organization.
  • Consent for Medical Treatment

    As the parent or legal guardian of the above-named participant, I hereby give my consent for emergency medical care prescribed by a duly licensed doctor. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.
  • Release from the Studio

    Youth attending heARTS have a wide range of autonomy. Please indicate what level of independence you would like for your child's release from the studio. You are welcome to adjust this option at any time.
  • By signing below, you grant permission for your child to attend programming, events, field trips, and service projects associated with Courageous heARTS. You also agree to hold heARTS harmless for accidents or loss/damage of personal property.
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