PARENTAL WAIVER AND MEDIA RELEASE FORM
As the parent or legal guardian of the child name below, I hereby give my full consent and
approval for my child to participate in the cookie class dictated by Bake N Glow. I understand
that there are certain risks of injury to any kind of activity. I am willing to assume these risks on
behalf of my child. I hereby certify that my child is fully capable of participating in the designated
class.
In addition to giving my full consent for my child’s participation, I do hereby waive, release and
hold harmless Bake N Glow, its supervisors and assistants from any and all damages, causes of
action, claims, and liability that might arise from my child’s participation in this class.
Initials of Parent/ Guardian__________
Media Release
I consent to and allow any use and reproduction by Bake N Glow of any and all photographs or
videos taken of my child(ren) during the participation in this class. I understand that Bake N
Glow will own the photographs and videos and the right to reproduce in any media, as well as
the right to edit them or prepare derivative works, for the purpose of promotion, advertising, and
public relations.
I hereby consent to this of my child’s name, likeness, or voice, and I agree that such use will not
result in any liability for payment to any person or organization, including myself.
Initials of Parent/ Guardian__________
_________________________ ______________
Signature
Date
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Name of parent/ guardian ( please print)
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Child’s full name
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Parent phone number
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Emergency contact person and phone number
Please list any physical limitations (allergies, hearing, sight etc)
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