*1.Participant's Information(Required.)

1st Participants
First Name:

Last Name:

2nd Participants
First Name:

Last Name:

3rd Participants
First Name

Last Name:

*2.Parent/ Guardian Name(Required.)

*3.Parent/ Guardian Email (So we can send confirmation & conference  information)(Required.)

*4.Parent/ Guardian Phone Number (So we can contact in case of emergency)(Required.)

5.Shirt Size? (Adult Size)

1st Participant
Shirt Size

2nd Participant
Shirt Size

3rd Participant
Shirt Size

6.Grade: 5th-12th

1st Participant
Age

2nd Participant
Age

3rd Participant
Age

*7.Tribal Affiliation:(Required.)

Salt River Pima-Maricopa Indian Community (Member/ Resident) 

Other (please specify)

*8.

COMMITMENT TO PARTICIPATE

You can count on my full participation in all sessions and activities of the 2025 Echoes of the Akimel Mural Fest. I pledge to conduct myself in a manner that will bring only credit to the Salt River Pima Maricopa Indian Community. I will treat all participants, presenters, chaperones, facilitators, and staff with respect. I pledge to wear my name badge around my neck and visible at all times. I pledge to remain drug, tobacco, and alcohol free during the entire conference.

Please type your signature (Participant )(Required.)

First Participant:

Second Participant:

Third Participant:

*9.

MEDICAL AUTHORIZATION/ LIABILITY RELEASE

If the participant is a minor, this form must be signed by a parent or legal guardian. I hereby approve the participation of my son/daughter in the 2025 Echoes of the Akimel Mural Fes. In the event of illness or accident, I give my consent for him/her to receive medical attention. Also, I will not hold liable the Salt River Pima-Maricopa Indian Community, or any of its agents, volunteers or other organizations involved in this conference. I will also be responsible for any damages to public or private property done by the above named minor during the entirety of above mentioned event.

Please type your signature (Parent / Guardian)(Required.)

Signature of Parent/ Guardian if participant 17 years or less.

First Participant if 18 years or more:

Second Participant if 18 years or more:

Third Participant if 18 years or more:

*10.

PHOTO RELEASE

By signature below I grant permission to photograph and/or film my child for use by the Salt River Pima-Maricopa Indian Community Youth Services or the media for the purpose of information the public of programs provided by the Salt River Pima-Maricopa Indian Community.

Please type your signature (Parent / Guardian)(Required.)

Signature of Parent/ Guardian if participant 17 years or less.

First Participant if 18 years or more:

Second Participant if 18 years or more:

Third Participant if 18 years or more:

*11.

Transportation Liability Waiver

BY signing below, I grant permission for my child, to travel in an SRPMIC Youth Services tribal vehicle for program-related activities. I understand that all participants must adhere to the Student Code of Conduct as outlined in the Commitment to Participate agreement.
Student Liability:
I acknowledge that if my child violates program policies or rules of conduct, they may be denied bus-riding privileges, suspended, or removed from the program. Any harm to persons or damage to property caused by my child may result in a report to the SRPMIC Police Department.

Parent/Guardian Liability:
I understand that I am responsible for any damages my child causes to community property while participating in this program, as outlined by state and tribal laws. I accept financial responsibility for any costs incurred due to such damages.

Please type your signature (Parent / Guardian)(Required.)

Signature of Parent/ Guardian if participant 17 years or less.

First Participant if 18 years or more:

Second Participant if 18 years or more:

Third Participant if 18 years or more: