LIABILITY, APPEARANCE AND IMAGE RELEASE
The John F. Kennedy Center for the Performing Art

The undersigned hereby acknowledges receipt and agreement with the following terms as a condition of the participation of the child named below, or for myself if I am over the age of 18 (the “Participant”) in the following Kennedy Center  Education program (the “Program”): Dance for Parkinson's Disease Workshop
COVID-19 Acknowledgements: I acknowledge that Participant will be required to provide proof of full vaccination against COVID-19 . “Full vaccination” means that either 14 days have passed since receiving the second dose of FDA or WHO authorized double-dose vaccines or that 14 days have passed since receiving the sole dose of FDA or WHO authorized single-dose vaccines. For any Participant who is not yet eligible for COVID-19 vaccination due to being under the age of 12, proof of a negative PCR test taken within 72 hours of any activity must be provided.

I acknowledge and agree that Participant shall comply with all guidelines, rules, regulations, and health and safety protocols imposed by any applicable governing authority and adopted by Center related to the Program and/or any standards related to COVID-19 or other public health emergency (the “Protocols”). The Protocols shall be reviewed and revised by Center based on the best practices then-current at the time of the Program, and may include, without limitation, providing proof of full vaccination, staggered arrival and departure times, alternate arrival and departure locations, temperature checks, regular sanitation requirements, physical distancing, required face coverings while not actively participating in the Program, modified food and beverage offerings, pre-arrival testing, and requirements that any persons developing or exhibiting symptoms leave the Center grounds. Notwithstanding the then-current Protocols, I specifically acknowledge that an inherent risk of COVID-19 exposure exists in any place where people are present. I, FOR MYSELF AND PARTICIPANT, VOLUNTARILY ASSUME ANY AND ALL RISK RELATED TO EXPOSURE TO COVID-19 ARISING IN ANY MANNER FROM THE PROGRAM.
Liability Release:  I, individually, and on behalf of the Participant’s heirs, successors, assigns and personal representatives, hereby agree to discharge, release, and hold harmless the John F. Kennedy Center for the Performing Arts (the “Center”) and all programs and affiliates thereof, and all artists engaged by them, their respective board members, trustees, officers, employees, agents and independent contractors, and the United States of America, from any and all liability whatsoever for any and all damages, losses, or injuries (including death) Participant sustains to person or property or both, including but not limited to any claims, demands, actions, causes of action, judgments, expenses and costs, including attorney’s fees, which arise out of, result from, occurring during, or are connected in any manner with Participant’s participation in the Program.
Appearance Release:  I authorize the Center, its contractors, and other individuals or entities under its direction and control, including artists, affiliates, subsidiaries, licensees, successors and assigns, to take photographs, video and sound recordings or other images or recordings which may include Participant’s likeness or image in connection with their participation in the Program.

By signing this form, I authorize the Center, and any others under its direction and control, to use any such photographs and recordings, as well as any materials created for or during the course of the Program, such as artistic works (which may include paper based artwork, musical compositions, dramatic compositions, dramatic works or creative writing) or written materials (together with any images, photographs or recordings, the “Materials”), in connection with Center publications, handouts, websites, presentations, videos, social media postings, documentary productions for non-commercial and commercial distribution, and other materials for use in connection with the Center’s performing arts mission and educational and institutional activities, which may include the creation of videos or other materials for distribution online or via hard copy among other non-profit entities with similar educational and/or artistic missions, any artist involved in the Program, or the advertising and promotion of Center’s educational and institutional programming. The rights granted to Center are  irrevocable, perpetual, worldwide, and include the right to use the Materials in any form, media, language or technology, now known or later developed.

I expressly acknowledge that the Materials may also be used in connection with press coverage related to the Center generally and/or Program, which may include photographs, video footage and interview responses. Unless I specifically opt out below, I expressly permit the Kennedy Center to disclose Participant’s name,  age, and address to members of Congress and state and local elected officials for purposes of broader awareness of Center’s educational programming.

I do not expect any compensation, monetary or otherwise, in exchange for the use of the Materials. I hereby waive any right of inspection or approval of the Materials or the uses to which such Materials may be put, and I understand that they may be used with or without direct attribution. I shall have no copyrights or other rights to the Materials or the uses thereof or any benefits derived from either. I acknowledge that Center will rely on this permission potentially at substantial cost to itself and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder, nor to seek any compensation for such use.
I represent that I am over the age of 18 years, and that I have read and fully understand the meaning of this release. If this form is completed on behalf of a minor child, I represent and warrant that I am the parent or legal guardian or am otherwise authorized to consent to such creation and use of materials as described herein on behalf of that child.
Please note that online sign up will end on 6/9/23 at 3 p.m. If you have any questions about the workshop, please contact KNTureaud@kennedy-center.org.

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* 1. To register, please complete the form below

The Kennedy Center may use the information you provide to contact you via mail, email, and/or phone to inform you of Kennedy Center news or offers. You may opt-out of these communications any time by visiting kennedy-center.org or calling (202) 416-8485.

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* 2. I hereby grant Center permission to release my contact and other information to my elected officials as stated above.

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* 3. Do you have any accessibility needs you would like to make us aware of? Tell us here, or you can contact our accessibility office at (202) 416-8727 or email our Dance Education team at kburke@kennedy-center.org.

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* 4. By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this liability, appearance, and image release.

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