Grades 6-12 InstaARTS Registration | Philadelphia Arts In Education Partnership

InstaARTS is supported in part by the Pennsylvania Council on the Arts, a state agency funded by the Commonwealth of Pennsylvania and the National Endowment for the Arts, a federal agency.

InstaArts

Student First Name*

Student Last Name*

Parent/Guardian First Name*

Parent/Guardian Last Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Enter Email Confirm Email

Phone*

School*

Current Grade Level*

Photo and Video Release*

I agree to photo and video release

In consideration of my son/daughter's engagement as a photo or video subject by the Philadelphia Arts in Education Partnership/PAEP, Northeastern Educational Intermediate Unit (NEIU) and the InstaAARTS program, I hereby grant the right and permission to copyright, use, reuse and publish photographs or videotape images made of my son/daughter for the InstaARTS program's educational purposes, including use in advertisements for public relations and development purposes. I hereby release PAEP/NEIU and its authorized representatives, including the photographer or videographer, from any liability by virtue of any blurring, distortion or alteration that may have occurred in the making of such images and from any liability for claims of libel or invasion of privacy for any reason.

Hold Harmless Agreement*

I have read and understand the Hold Harmless Agreement

As a parent/guardian of a participant in the PAEP/NEIU sponsored InstaARTS program, I understand that PAEP/NEIU does not provide any medical insurance coverage for the accidental injuries or illness or coverage for accidental injuries or illness or coverage for personal property damage. I agree to release and hold harmless, PAEP/NEIU and the InstaARTS program from any and all responsibility for any injuries or damages not directly caused by negligence of the program its officers, agents, or employees.

Parental Consent*

I have read and understand the Hold Harmless Agreement

I give my permission for my son/daughter to attend the InstaARTS program. I understand that during the course of the program the students will participate digitally via Zoom.

Parent / Guardian Signature*