[ Movie Camp Home Page ]

[ Script to Screen Basics ] [ Script to Screen Advanced ]

[ Camcorder FUNdamentals ] [ Community Documentary Filmmaking ]

[ The Digital Flipbook ]

 

FORM PRINTS BEST WITH 1/2 INCH LEFT AND RIGHT PAGE MARGINS

 

This completed Risk and Consent Form must accompany the Registration Form for any of the workshops offered during the T Tauri Film Festival. Send the completed Risk and Consent Form, a completed Workshop Registration Form, and a check or money order for the appropriate workshop fee to:

 

T Tauri Film Festival, 195 Peel Road, Locust Grove, AR 72550

 

 

T TAURI FILM FESTIVAL WORKSHOP RISK AND CONSENT FORM

 

STUDENT INFORMATION

 

Name:

 ______________________________________________________________________________

 

Mailing Address:

______________________________________________________________________________

 

Phone(s):

______________________________________________________________________________

 

Email:

______________________________________________________________________________

 

Entering Grade:

 ________________

 

PARENT/GUARDIAN INFORMATION

 

Name:

 ______________________________________________________________________________

 

Mailing Address:

______________________________________________________________________________

 

Phone(s):

______________________________________________________________________________

 

Email:

______________________________________________________________________________

 

Check the workshop your child will attend:

 

____ Script to Screen Basics          ____ Script to Screen Advanced      ____ Camera FUNdamentals

 

____ Documentary Filmmaking      ____ Acting on Camera                 ____The Digital Flipbook

 

 

ACKNOWLEDGMENT OF RISK AND CONSENT FOR TREATMENT:

I acknowledge that there may be certain dangers, hazards, and risks associated with my child's participation in this activity. I further acknowledge and

understand that all risks cannot be prevented. I assert that my child is physically and mentally able, with or without accommodation, to participate in

this activity, and is capable of using the equipment, if any, associated therewith. I agree to assume all the risks and responsibilities surrounding my

child's participation in this activity, and agree to release from liability and waiver any legal action against the T Tauri Film Festival or Ozark Foothills

FilmFest, its governing board, officers, agents, employees, and volunteers, for any personal injury or property damage suffered by my child while

participating in this activity or while in transit to or from the premises where the activity is being conducted

 

I understand that the T Tauri Film Festival does not provide or have medical services or personnel available at the location of the activity. In case of

medical emergency, I understand that every reasonable attempt will be made to contact me, my family physician, or the emergency contact named

below. However, in the event that I or my named contacts cannot be reached, I give my permission to the adults supervising the T Tauri Film Festival

filmmaking workshops to secure emergency medical treatment for my child. I agree to pay for any charges for emergency medical treatment that are

not covered by my personal health insurance. In the event that personal transportation is used to convey my child to a medical facility, it is expressly

understood that the T Tauri Film Festival and Ozark Foothills FilmFest incur no responsibility or liability in the event of an accident or other damages to

vehicles or property or injury to drivers or passengers either on the way to or from the facility, or while at the facility.

 

This acknowledgment applies to the workshop indicated above and any additional activities of the 2008 T Tauri Film Festival for which I may subsequently

register my child.

 

Signature of Parent

or Guardian:

 ______________________________________________________________________________

Emergency Contact

(other than parent):

 ______________________________________________________________________________

Emergency Contact

Phone:

______________________________________________________________________________

Health Insurance Co.

and Policy No.:

______________________________________________________________________________

Family Physician

Name and Phone:

______________________________________________________________________________

 

 

MEDIA RELEASE:

 

I give my permission for my child to be photographed, filmed, and interviewed, and to have work samples produced totally

or partially by my child to be published in print, in video, and/or on the internet.

 

Signature of Parent

or Guardian:

 ______________________________________________________________________________

Parent or Guardian

Name (please print):

______________________________________________________________________________
 

[ 2008 Workshops ] [ 2007 Photo Gallery ] [ 2007 Best of T Tauri DVD ]