Celebrating 10 Years in Greenwich!

"Filmmakers Ink is outstanding!...Ilove your program!...This was betterthan my wildest dreams!...We laughed

and laughed!"

Child's Name/Age:_____________________________________________ Home Phone______________________________

Parent's Name___________________________________________________ Cell Phone_____________________________

Medical Concerns_____________________________________________________ Email____________________________

Address_____________________________________________________________ Program________________________________

Total Enclosed______________

I, the parent/legal guardian of the above named child, do hereby give my permission for

my/his/her participation in activity entered above. I assume all risks and hazards

incidental to such participation. I do hereby waive, release, absolve, indemnify and

agree to hold harmless for myself and/or the above named child, the Greenwich

recreation division, the organizers, Filmmakers Ink staff & participants.

__________________________________________________

Parents or Legal Guardian Signature/Date

Learn with the Pro's

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