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SPLECC Evening Programs

Art for All with Mr. Paul High Horse Registration

Fall Art For All Classes at SPLECC 1500 N 16th St., Council Bluffs, IA 51501
Please select which Art Class you are signing up for. For questions, please call 712-322-3294 or email: [email protected] or [email protected]
Name
Address
Artistic Experience
Emergency Contact Name
Liability Waiver Agreement
“Participants and their parents hereby agree to indemnify and hold harmless St. Paul’s Evangelical Lutheran Church of Council Bluffs, IA, its officers, board members, employees, and volunteers, from and defend against all claims brought or actions filed, for any and all claims, suits, actions debts, damages, costs, charges, and expenses including court costs, and attorney’s fees, and against all liability, losses, and damages of any nature whatsoever, including but not limited to property damage and personal injury, including death resulting at any time there from, arising from any alleged acts of negligence, either active or passive, of the participant or any person acting on his/her/its behalf arising from the activities which are the subject matter of this contract.”
Photography / Social Media Waiver
I hereby give permission for photographs taken during Camp Creation I to be used by St. Paul’s Evangelical Lutheran Church of the above student(s) to be used for promotional purposes, including fliers, websites, Facebook, Instagram (Social Media Pages), news features, etc.
Please enter today’s date
Parental Consent Signature
Please enter your full legal name to acknowledge the Liability & Photograph/Social Media Permission Waiver. NOTE: Only needed for participants under the age of 18.