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Modern Ancient Glass

Please print, sign and return Release with Application and Deposit or Payment.

Please read carefully and sign .

I understand and agree that participation in Kiln-Glass classes are voluntary. I assume all risks and voluntary release, waive and relinquish any and all claims, causes of action and liability for any personal injury or property damages (actions) arising out of my / or my child’s participation in these classes, including any alleged negligence in the operation or maintenance of the property and facilities on which such classes are held. I agree to hold JVAC and their respective members , agents and employees harmless from and against actions, which may arise out of, or in the connection with my and / or my child’s participation in JVAC classes. I read, understand and agree to the terms of this release.

Parents /Guardian signature

In the event of emergency and if I can nmot be reached, I give permission to authorize any medical treatment deemed necessary by the attending physician. I read, understand and agree to the terms of this release.

Parents /Guardian signature Date: 

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