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STEM Club Full Release of Liability & Waiver Agreement

Please read this form carefully and be aware in registering your child(ren) for participation in The Wonder Lab's STEM Club drop-off care program you will be waiving and releasing all claims for injuries your child(ren) might sustain arising from that program.


If you have more than one child attending please list them all on this form.


If you have already filled out this form for your child(ren) for any STEM Club session you do not need to fill it out again. If you would like to update or change any information please contact us at info@wonderlabdurham.com or at 919-213-8527.

Child's DOB
Month
Day
Year
Additional child's DOB
Month
Day
Year
Additional child's DOB
Month
Day
Year

Medical Information

Emergency Contacts

Please list at least one emergency contact other than yourself. Persons listed must be reachable during STEM Club hours (Tuesdays from 2:00 - 4:30 PM). In case of an emergency we will attempt to reach out to you first. If we are not able to get in touch with you we will reach out to these contacts in the order they are listed.

Important Information

The Wonder Lab is committed to conducting its programs and activities in the safest manner possible and holds the safety of participants in the highest possible regard. Participants and parents registering their children in programs and activities must recognize, however, that there is an inherent risk of injury when choosing to participate. The Wonder Lab strives to reduce such risks and insists that all participants follow safety rules and instructions which have been designed to protect the participant's safety.


Liability Release

I recognize and acknowledge that there are certain risks of physical injury to participants in The Wonder Lab's STEM Club program(s) and I agree to assume the full risk of any injuries, damages or loss regardless of severity which I or my child may sustain as a result of participating in any and all activities connected with or associated with such program(s). I agree to waive and relinquish all claims I or my child may have against The Wonder Lab and its officers, agents, volunteers and employees as a result of participation in the program. I do hereby fully release and discharge The Wonder Lab and its officers, agents, volunteers and employees from any and all claims from injury, damage or loss with the activities of the program(s). I further agree to indemnify and hold harmless and defend The Wonder Lab and its officers, agents, and employees from any and all claims resulting from injuries, damages, and losses sustained by me or my child arising out of, connected with, or in any way associated with the activities of the program(s).


Permission to Secure Treatment

All of The Wonder Lab's educators are certified in First Aid & CPR. They will take whatever emergency medical measures are deemed necessary for the protection and safety of all children within their training.


In the event of any emergency, I authorize The Wonder Lab to secure from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for me or my minor child/ward's immediate care and agree that I will be responsible for payment of any and all medical services rendered.


Photography & Video Release

The Wonder Lab’s staff may take pictures and/or videos during class to use for marketing material, staff training, or social media sites controlled by The Wonder Lab. Participant’s names will not be published when photo or video clips are used and no monetary compensation will be given. You have the right to decline for photos of your child to be used. By granting permission to The Wonder Lab, its agents, and its employees the irrevocable and unrestricted right to produce photographs and video taken of your child, you are also granting permission for The Wonder Lab to use said photographs & videos for any lawful purpose including publication, promotion, illustration, advertising, trade, or historical archive in any manner or in any medium by The Wonder Lab.

Please choose one
I grant The Wonder Lab, and all its agents, permission to use my child(ren)'s photographs and/or videos.
I do not grant permission for my child(ren)'s photographs and/or videos to be used by The Wonder Lab.
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3709-A University Drive Durham, NC 27707

919-213-8527

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