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Liability Waiver / Intake Form*

LIABILITY WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND EMERGENCY MEDICAL AUTHORIZATION

*Before completing registration, please complete this Liability Waiver and Emergency Authorization Form.

Student Birthday
Month
Day
Year

Program: Summer Art Travel Program

If none - put n/a

Name has to match ID

Photography and Media Release
YES, I grant permission for photographs and video recordings of my child to be used by Julia iSABEL Art Academy for educational, promotional, marketing, website, social media, and archival purposes.
NO, I do not grant permission.

Acknowledgment of Participation

I, the undersigned parent or legal guardian, authorize my child to participate in the Julia iSABEL Art Academy Summer Art Travel Program (“Program”), operated by Wallprint US LLC and directed by Iuliia Rybchynska, professionally known as Julia iSABEL. Participation may include transportation to and from museums, galleries, artist studios, cultural institutions, educational facilities, outdoor locations, and related activities.


Assumption of Risk

I understand that participation in the Program involves inherent risks, including but not limited to:

• Transportation by motor vehicle

• Walking in public spaces, parking areas, sidewalks, and transportation hubs

• Museum, gallery, artist studio, and educational facility visits

• Outdoor activities and changing weather conditions

• Accidental slips, falls, trips, collisions, or other injuries

• Illness, injury, medical emergencies, or other unforeseen circumstances

I voluntarily assume all risks associated with my child’s participation in the Program.


Release of Liability

To the fullest extent permitted by law, I release and hold harmless Wallprint US LLC d/b/a Julia iSABEL Art Academy, Iuliia Rybchynska (professionally known as Julia iSABEL), Studio 9, their employees, assistants, contractors, volunteers, agents, representatives, affiliates, successors, and assigns from any and all claims, demands, actions, damages, losses, liabilities, costs, expenses, or causes of action arising from or related to my child’s participation in the Program, except where caused by gross negligence or willful misconduct.


Transportation Authorization

I authorize my child to travel with Program staff and authorized representatives to Program destinations.

I understand that transportation may be provided in privately owned, leased, rented, or otherwise authorized vehicles operated by approved adults.

I agree that my child will comply with all transportation safety requirements, including wearing a seat belt at all times while a vehicle is in operation.


Medical Information

I certify that all known allergies, medical conditions, medications, dietary restrictions, behavioral concerns, and other relevant health information have been disclosed accurately.

I understand that failure to disclose relevant medical information may increase risks to my child and may limit the Program’s ability to respond appropriately in an emergency.


Emergency Medical Authorization

In the event of illness, injury, accident, or medical emergency, and if I cannot be reached immediately, I authorize Program staff to obtain emergency medical treatment for my child as deemed reasonably necessary.

I understand that I am solely responsible for any resulting medical, transportation, hospital, physician, pharmaceutical, or related expenses.


Behavioral Expectations

I understand that students are expected to conduct themselves respectfully, responsibly, and safely at all times.

Wallprint US LLC d/b/a Julia iSABEL Art Academy reserves the right to remove a student from the Program for behavior that is unsafe, disruptive, abusive, unlawful, or otherwise detrimental to the Program, staff, participants, partner institutions, or the public. No refund shall be required in such circumstances.


Severability

If any provision of this Agreement is found unenforceable, the remaining provisions shall remain in full force and effect.


Governing Law

This Agreement shall be governed by the laws of the State of Connecticut.


Acknowledgement

I certify that:

  • I am the parent or legal guardian of the Student;

  • I have carefully read this Agreement;

  • I understand its contents;

  • I voluntarily agree to its terms on behalf of myself and my child.

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CONTACT

203-305-0274

contact@juliaisabel.com​

Studio visits and artwork
inquiries are welcome.

VISIT

MNTD Studios,

STUDIO 9, 2nd floor,

800 Union Ave,

Bridgeport,
CT 06608

By appointment and
during public events.

FOLLOW

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HUG

Artsy

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