Media:

I grant permission for Girls Rock Math to capture still or motion picture images of me/my child and/or audio recordings of my child's voice while participating in GRM programs or events for use on the Girls Rock Math website, promotional/marketing or outreach purposes, including but not limited to electronic or print materials, or print, social or broadcast media. Girls Rock Math will never sell still/motion picture images or audio recordings to parties beyond the organization. If I do not want my child's image used by Girls Rock Math I will complete the additional Photo Opt-Out form and deliver it to the staff at my child's camp on the first day of the program.

Camp Policies:

I have read, understand and agree to all camp policies as described on the Camp Policies page on the Girls Rock Math website, including but not limited to the following:

• Financial Policies
• Cancellation Policy
• Health and Safety Policies
• Disclosure Policy
• Behavior Policy
• Equity and Diversity Policy

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AND PARENTAL CONSENT AGREEMENT

In consideration of being permitting to participate in a Summer Camp ('the Camp') at Girls Rock Math ('Camp'), I the undersigned, on behalf of the Participant:

ACKNOWLEDGEMENT

ACKNOWLEDGE, agree, and represent that I understand the nature of the Camp and that the Participant is in good health, and in proper physical condition to participate in the Camp. FULLY UNDERSTAND THAT: (a) Participation in the Camp at Girls Rock Math is voluntary, and involves risks and dangers of bodily injury *; (b) these Risks and dangers may be caused by the Participant's own actions or inactions, the actions or inactions of others participating in the Camp, the condition in which the Activity takes place; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the participant in the Camp.

AGREEMENT

AGREE TO ABIDE by all rules promulgated by Girls Rock Math while the Participant, or Participant's family member or guest, including any minors, are present in, observing, using, or participating in any Camp activities or while visiting the Camp facilities at Girls Rock Math.

COOPERATION

AFFIRM MY COOPERATION with the Girls Rock Math Health & Safety policy. I acknowledge that I have read, understood, and agree to the terms and conditions of the policy and its protocol. I will abide by the directions provided to me by Girls Rock Math Staff and representatives. Girls Rock Math reserves the right to escort any individual or party off of the property if any of the aforementioned terms are violated by an individual or party, in effort to protect the health and safety of anyone on the property, including the public, Girls Rock Math employees, Directors, or affiliates.

HOLD HARMLESS

HEREBY RELEASE, HOLD HARMLESS Girls Rock Math, their respective administrators, directors, members, volunteers, and employees, Camp Staff, other participants, or owners of premises on which the Camp takes place from all liability, claims, demands, losses, or damages on my account causes or alleged to be cause in whole or part by the negligence of Girls Rock Math or otherwise, including negligent rescue or first aid operations. I further agree to WAIVE ALL CLAIMS against Girls Rock Math and/or its representatives, including, but not limited to, claims for property damage, personal injury, or death arising from or related to the enrollment of the Participant in Girls Rock Math programs and activities, made by anyone on my behalf or on the behalf of the Participant. ASSUME FULL RESPONSIBILITY for any items lost, stolen, or damaged while myself, or the Participant is present in, observing, using or participating in the Camp.

RESPONSIBILITY

ACCEPT FULL RESPONSIBILITY and liability for and indemnify Girls Rock Math and its representatives against the cost of treatment, transportation, or any other costs incurred for the treatment of any injury suffered by the Participant, the Participant's family members, or guests while participating in activities or programs at Girls Rock Math.

CONSENT TO MEDICAL TREATMENT

CONSENT TO THE TREATMENT, to include first aid and CPR, of the Participant by Camp Staff, as they deem appropriate. GIVE PERMISSION for the Participant be transported by ambulance, treated by aid car personnel, and/or transported to an emergency medical center/hospital for treatment. I further authorize and consent to the medical, surgical, and hospital care, treatment, and procedures to be performed for the Participant by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard the participant's health.

UNDERSTANDING

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND that I have giving up substantial rights by signing it and release all liability to the greatest extent allowed by law. If any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.