Waiver

Curious by Nature Program Waiver

Please complete all sections below prior to attending

You may also download a copy of this form, print it and bring with you to your child's first class

1. PHOTO & VIDEO CONSENT

During activities at Curious by Nature Enrichment Club, photographs and/or videos may occasionally be taken of children participating in classes, activities, projects, special events, or outdoor experiences.

I understand that photographs or videos may be used for purposes such as:

• Curious by Nature Enrichment Club's website

• Social media pages

• Promotional materials, flyers, brochures, or newsletters

• Classroom or program displays

• Other materials used to share information about the program

I understand that my child's name will not be included with photographs or videos unless I provide separate permission.

2. INJURY & ACCIDENT

I understand that children participating in enrichment activities may participate in hands-on projects, games, movement activities, outdoor play, nature exploration, experiments, baking, art activities, and other age-appropriate activities.

I understand that, despite reasonable supervision and safety precautions, children may occasionally experience minor injuries or accidents, such as bumps, scrapes, falls, cuts, spills, or other injuries that can occur during normal childhood activities.

I understand that Curious by Nature Enrichment Club will make reasonable efforts to provide a safe environment, supervise children appropriately, and respond to injuries or accidents when they occur.

I authorize Curious by Nature Enrichment Club staff to provide basic first aid and to contact me or my emergency contact if my child is injured or becomes ill.

If an emergency occurs and a parent/guardian or emergency contact cannot be reached, I authorize appropriate emergency medical personnel to provide necessary emergency care to my child.

I understand that this consent does not prevent me from seeking appropriate medical care for my child or from exercising any rights I may have under applicable law.

3. NATURE WALKS & OUTDOOR

EXPLORATION

Curious by Nature Enrichment Club may offer activities that take place outdoors, including nature walks, hikes, scavenger hunts, outdoor exploration, seasonal activities, and exploration of natural surroundings.

I understand that outdoor activities may involve naturally occurring risks, including but not limited to:

• Uneven or slippery ground

• Rocks, sticks, roots, mud, and other natural obstacles

• Insects and other wildlife

• Plants, including plants that may cause irritation

• Weather conditions

• Minor falls, bumps, scratches, or other common outdoor injuries

I understand that reasonable precautions and supervision will be provided, but outdoor activities cannot be completely free of risk.

4. CLOTHING & PERSONAL BELONGINGS

I understand that many Curious by Nature Enrichment Club activities are designed to be hands-on and may involve materials such as:

• Paint

• Glue

• Markers

• Dirt

• Mud

• Leaves

• Water

• Food and baking ingredients

• Nature materials

• Sensory materials

• Other art, science, or activity supplies

Reasonable care will be taken to help protect children's clothing and belongings. However, I understand that clothing, shoes, backpacks, or other personal belongings may become stained, wet, dirty, damaged, or otherwise affected during participation.

I understand that Curious by Nature Enrichment Club is not responsible for ordinary wear, stains, damage, or loss of personal belongings resulting from participation in activities.

5. Play Equipment & Outdoor Play

I give permission for my child to use the play equipment available at Curious by Nature Enrichment Club during supervised outdoor play and activities. This may include playground equipment, climbing structures, slides, swings, and other age-appropriate outdoor play equipment.

Trampolines are specifically excluded. Children are not permitted to use or play on any trampoline while attending Curious by Nature Enrichment Club.

I understand that outdoor play and the use of play equipment involve normal risks such as falls, bumps, scrapes, or other minor injuries.

6. PARENT/GUARDIAN

ACKNOWLEDGMENT

By signing below, I acknowledge that I have read and understand the information contained in this form.

I understand that Curious by Nature Enrichment Club provides enrichment activities and that participation may include indoor, outdoor, hands-on, messy, physical, creative, and nature-based activities.

I understand that reasonable safety precautions and supervision will be provided, but no activity involving children can be guaranteed to be completely free of risk.

I have had the opportunity to ask questions about the activities and policies described in this waiver.

I understand that this waiver is intended to document my informed consent and acknowledgment and is not intended to waive any rights that cannot legally be waived under Connecticut law.

1 Photo Consent: Please Choose One:*

YES, I give permission for my child to be photographed and/or recorded for the purposes listed above.

NO, I do not give permission for my child to be photographed or recorded for promotional purposes.

2 Injury & Accident Acknowledgement: *

I Acknowledge and Understand Section 2

3 Nature Walks & Outdoor*

I give permission for my child to participate in age-appropriate outdoor and nature activities.

4 Clothing & Personal Belongings*

I agree to send my child in clothing and footwear appropriate for the day's activities, particularly when outdoor, messy, or hands-on activities are planned.

5 Play Equipment & Outdoor Play*

I understand that reasonable supervision and safety rules will be provided, and I agree that my child will follow all safety instructions while using the equipment.

Medical Information

Medications/EpiPen or other emergency medication:

Other important information:

Child's Name*

Parent or Guardian's E-Signature

Emergency Contact

Emergency Contact's Phone Number*

Relationship to Child