Please list any medications, disabilities and/or food allergies: (Any child/children with medical conditions identified per their application, will be reviewed by our medical advisory team)


In case of medical emergency, your staff is authorized to take my child to urgent care or arrange for transportation to the hospital for emergency care.
I hereby grant and assign The How BIG Is Your Dream?! Foundation the non-exclusive right and permission to re-use, publish, re-publish, modify, and otherwise reproduce, and display in any and all media, for any purpose whatsoever, without compensation to the child, parents, guardians, or teacher, the use of my child's photo in connection with my or their participation in the How Big Is Your Dream Programming. I, being the parent or guardian of the above-named minor(s), hereby consent to the forgoing waiver and release and consent on behalf of said minor(s).
I understand that I am being informed in writing by checking the box below this acknowledgement, that this program is not licensed and is not required to be licensed by the state.

MINOR STUDENT ARTISTS AUTHORIZED RELEASE LIST (WHEN ONSITE)

If for some reason someone who is not on this list must pick up your minor child, you must send written permission.  (A telephone call is not acceptable.)   Furthermore, individuals picking up your child will have to present proper ID prior to pick up.

THE FOLLOWING PEOPLE HAVE PERMISSION TO TAKE ABOVE NAMED CHILD/CHILDREN FROM THIS CAMPUS:

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