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I, ______________________, parent or legal guardian of ____________________(the “Student”), hereby give my consent to the Student’s participation in ChickTech: High School 2019 (a year-long program that runs from November 2019 to as late as October 2020). I understand that the Student may be transported to and from the ChickTech: High School 2019 events and that the Student may be engaged in activities such as soldering, working with tools, computers or other equipment. The Student will be supervised by ChickTech volunteers during the scheduled ChickTech: High School events.

In consideration of the permission granted to me and to the Student for the Student to participate in ChickTech: High School 2019 the undersigned parent or legal guardian, to the extent permitted by law, do hereby:

(1) assume any and all risk and liability for all losses, damages, damage to property, injuries or death to the Student which may arise in connection with travel to/from or participation in ChickTech: High School 2019 sponsored by ChickTech or its affiliates, and hereby, for the Student and for myself and our heirs, executors, administrators, successors and assigns, do release and discharge the ChickTech and each of its affiliates, officers, directors, employees, volunteers, predecessors, successors, representatives and assigns (collectively “ChickTech”), from any and all claims, actions, and liabilities arising from or relating to with travel to or participation in activities, programs or functions of ChickTech: High School 2018, and;

(2) grant permission for videographic, photographic or audio recording of the Student’s participation in the activities, programs or functions of ChickTech: High School 2019, and for the use of such recordings by or with the consent of ChickTech for promotional and educational purposes.

This consent form will remain in effect until October 31, 2020.

I, the undersigned, have carefully read the foregoing consent and release form and know and understand the contents thereof. I sign this consent and release voluntarily and with knowledge of its significance, and intend to be legally bound thereby.

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ChickTech is a registered 501(c)3.