Studio49 Minor Consent Waiver

Studio Name:     Studio49______     
Studio Address: _____129 S Main St. Livingston, MT_______
Email: _________project49mt@gmail.com_______________

Participant Information (under 18)

• Full Name of Minor: ___________________________________

• Date of Birth: ___________________________________

• Age: ______

• Address: ___________________________________

• City, State, ZIP: ___________________________________

Parent/Guardian Information

• Full Name of Parent/Legal Guardian: ___________________________________

• Relationship to Minor: ___________________________________

• Phone Number: ___________________________________

• Email: ___________________________________

Emergency Contact (if different from above)

• Name: ___________________________________

• Relationship: ___________________________________

• Phone Number: ___________________________________

Additional Contacts & Guardian(s) (if different from above)

• Name(s): __________________________________________________

____________________________________________________________

• Relationship(s): ______________________________________________

_______________________________________________________________

Consent and Acknowledgment

I, the undersigned parent or legal guardian of the above-named minor, hereby give permission for my child to participate in art activities, workshops, classes, and events held at Studio49.

I understand and acknowledge the following:

1. Supervision & Behavior: I understand that my child will be supervised during scheduled activities by community volunteers and Studio49 Staff, but that the studio is not responsible for the child outside of these hours. I agree that my child will follow all studio rules and instructions from staff.

2. Art Materials: I understand that the studio may use various art materials (e.g., paints, glues, clays) that can be messy or mildly hazardous if misused. I consent to my child’s use of these materials under supervision.

3. Health & Allergies: I confirm that I have informed the studio of any relevant health concerns or allergies.

• List any known allergies or medical conditions: ____________________________

• Medications (if any): ____________________________

4. Injury Waiver: I acknowledge that participation in art activities carries some risk of minor injury (e.g., cuts, allergic reactions). I release Studio49 and its staff from liability in the event of accidental injury, except in cases of gross negligence.

5. Photo/Video Consent: By signing this form, you acknowledge and comply with the use of any photo or video content taken inside Studio49 specifically for the use of marketing and media materials. If you would like to opt out, please let us know. 

6. Supervision Requirements: I acknowledge that my child

• Is under the age of 10 and will have a parent, guardian, or caretaker over the age of 16 responsible for them while at Studio49

• Is over the age of 10 and does not have a parent, guardian, or caretaker present with them while at Studio49, and is therefore responsible for all conduct

7. Studio49 Policies and Procedures: 

• I have read through and agree to the following policies as seen in Studio49 Handbook (available on website and physical copy on site)

1. Studio49 Assumption of Risk Policy 

2. Studio49 Participation Notice 

3. Studio49 Rules of Conduct

Signature

By signing below, I acknowledge that I have read, understood, and agree to the terms of this consent form for Studio49.

Parent/Guardian Signature: ___________________________
Printed Name: ___________________________
Date: ___________________________