Program Participation and Liability Waiver Home – Forms – Program Participation Waiver Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Participant Name *Parent/Guardian Name (if under 18) *If over 18, please place "N/A" in this fieldAcknowledgment of Participation *I understand that my child is voluntarily participating in programs hosted by Period Zero, including Teen Networking Nights and related activities held at partner locations.Assumption of Risk *I understand that participation in program activities may involve inherent risks, including but not limited to movement within event spaces, interaction with peers and guest speakers, and participation in group activities. I voluntarily assume all risks associated with my child’s participation.Release of Liability *I release and hold harmless Period Zero, its officers, staff, volunteers, partners, and event hosts from any and all claims, liabilities, damages, or expenses arising from participation in the program, except in cases of gross negligence or willful misconduct.Medical Acknowledgment *I confirm that my child is able to safely participate in program activities. I understand that Period Zero does not provide medical services and is not responsible for medical expenses. In the event of an emergency, I authorize Period Zero to seek appropriate medical care if I cannot be reached.Code of Conduct I understand that students are expected to: • Participate respectfully • Follow instructions from program staff • Engage appropriately with peers and guest speakers Code of Conduct *I acknowledge that failure to meet these expectations may result in removal from the program. Acknowledgment Participation of Transportation Responsibility *I understand that transportation to and from the program location is the responsibility of the parent or guardian. Period Zero is not responsible for supervision before or after scheduled program times.Photo and Media Acknowledgment *I understand that media consent is handled separately through the Period Zero Media Release Form.Agreement By signing below, I acknowledge that I have read and understand this waiver and agree to its terms. Parent/Guardian/Participant Electronic Signature * Clear Signature Participant Signature if 18 or older*Date *Submit
