Relase Form
Let us do this part
Today's Date:
Tue Apr 16 2024 05:44
Please read and answer
Makerspaces are all sorts of fun but also dangerous with hot soldering irons, sharp pointy things and fast moving power tools.

By signing this agreement, I acknowledge the risks of injury, property damage, or death resulting from the use of potentially dangerous tools or materials, even if the risks are unknown to me.
I hold harmless MAKE SOUTH BEND and its respective members, employees, instructors and directors (collectively "MAKE SOUTH BEND") and release MAKE SOUTH BEND from all liability, claims, damage, or demands arising from or related in any way to being a member or guest of MAKE SOUTH BEND or your participation in any MAKE SOUTH BEND activity, whether caused by negligence of MAKE SOUTH BEND or otherwise.
I agree to let MAKE SOUTH BEND use any recordings of my awesome image and/or voice for any purpose. I release MAKE SOUTH BEND and waive any claims related to or arising by reason of the making and/or use of any such recordings.

*Please alert staff if you do not agree to have your image or voice used so we refrain from recording you. We just like to share photos of real people making cool things in our makerspace.

I am of sound body and mind and voluntarily elect to participate in MAKE SOUTH BEND activities with knowledge of the hazards involved. I accept personal responsibility for my safety and actions and will follow all safety instructions and signage while at MAKE SOUTH BEND.
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.
Date of birth:*
If you are under 18 your parent/guardian will be required
Phone #:
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Photo ID
Please take photo(s) of your government issued photo IDs and related paperwork.