I hereby grant permission to the Director of Eastern Connecticut Ballet (ECB) or anyone designated by the Director, and to those persons listed as emergency contacts to authorize emergency medical or surgical treatment, including, but not limited to, blood or blood product transfusions, diagnostic procedures, and the administration of anesthesia, for Student where medically appropriate in case of injury, accident, or illness.
This authorization is given for the benefit of Student. The authorization given to the Director is given with the understanding that the Director, or the Director's designee, (1) will act only in my absence, and (2) will act only until such time as I or my spouse or the Student's legal guardian or the persons designated below can be contacted. I understand that the medical appropriateness of such treatment shall be determined by the attending physician or by the medical facility's medical staff, and that such a determination shall be conclusive evidence of the reasonableness of the consent given. I agree to hold the Director, anyone designated by the Director, ECB and any employees, officers and directors of ECB harmless from liability arising from any and all medical treatment, or complications arising there from, rendered as a result of consent given pursuant to this authorization.
I further authorize (1) the release by ECB or by the persons listed to the health care provider of such medical and personal information as ECB or the persons listed may have regarding Student, and (2) the use of such information by the health care provider in the subsequent medical treatment of Student.
I hereby give permission for images of my child, captured during ECB classes, rehearsals, special events, and performances through video, photo, and digital camera, to be used solely for the purposes of ECB promotional material and publications, and waive any rights of compensation or ownership thereto.
ECB promotional material is inclusive of but not limited to ECB marketing materials, brochures, information packets, videos, website photos, dance related newspaper and magazine articles, all social media including but not limited to: Facebook, and Instagram pages.
We at ECB collect group and individual photos and testimonials relating to our school, training, performances, and activities. We use these photographs, videos, profiles, testimonials and stories for various purposes, such as promotional advertising, commercial, educational, research, and archival purposes.
By signing this document, you are granting ECB permission to use your photo, profile, and/or story in promotional material to promote our school program and performances.