CONSENT FORM
This form is required for participation in Children’s Workshops in Art + Creativity, the Middle School Program, and the
Early College Program, and is valid and for one term. Forms must be signed, as typed names cannot be accepted.
ACKNOWLEDGMENT and AGREEMENT
Medical: I give SAIC permission to obtain emergency medical care, hospital, or clinic treatment for me. I hereby waive
liability against SAIC for such care and for transportation provided to such locations as deemed necessary by SAIC.
Rules of Conduct: I have read and agree to abide by the SAIC Rules of Conduct listed online in Forms and Downloads. If
in ECP, I have read and agree to abide by the SAIC Student Rights and Responsibilities listed online.
Photo/Video: I give SAIC permission to video or photograph me participating in instructional and/or social activities at
SAIC and to publish such videos or photographs. I agree to the forgoing on behalf of myself/my child or ward.
Participation in Field Trips
In consideration of my minor child or ward (“Student”) being allowed to participate in any field trip conducted as part
of SAIC’s Youth Programs, I do hereby, for myself, the Student and my dependents, heirs, executors, administrators,
agents and assigns, agree to waive, hold harmless, indemnify, covenant not to sue, release, and forever discharge the Art
Institute of Chicago, the School of the Art Institute of Chicago and their trustees, ocers, employees, members, agents,
successors, and assigns (hereafter collectively referred to as “Releasees”), for and from any and all responsibility, liability,
causes of action suites, damages, demands, and claims whatsoever which I, the Student or those claiming under either of
us may have, suer, or incur now or in the future resulting from or arising out of the Student’s participation in said field
trip and any direct or indirect event in connection therewith occurring before, during and/or after said trip, including,
but not limited to claims for death, personal injury, property damage or loss, whether arising out alleged strict liability,
negligence of Releasees, or otherwise.
On behalf of myself and the Student, I further agree to indemnify and hold harmless said Releasees of and from all
liabilities described above, arising out of or connected with the Student’s participation in said field trip, including any
claims of third persons relating to the above matters, whether by subrogation or otherwise.
Parent/guardian signature: Date:
MIDDLE SCHOOL PROGRAM (AGES 10-13) ONLY:
Permission for Unescorted Dismissal
Students are not permitted to leave campus unescorted without prior written approval indicated on the Consent Form
(last section). If you prefer to allow your child to leave at the end of class without the presence of an approved parent
or guardian holding a pick up pass, complete this part of the consent form by checking “yes” and signing. (Not valid for
students in Children’s Workshops in Art and Creativity or the Early College Program).
My child/ward may leave unescorted at time of class dismissal. YES NO
Parent/guardian signature: Date:
Student Name:
ID Number:
Class Number(s):
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