CHILDREN'S COURSE'S | Eden Ceramics

Child Pottery Course Registration & Parental Consent / Liability Waiver Form

Child's Full Name

Any relevant experience with pottery/art? (e.g.beginner, done clay before)

Birthday

Day

Month

Year

Parent/Guardian Information (must be completed by a parent/legal guardian):

Full Name

Relationship to Child

Phone (mobile preferred):

Address

Emergency Contact (someone other than the parent/guardian):

Full Name

Relationship to Child

Phone Number

Medical & Health Information (confidential – for safety only):

Does the child have any allergies (e.g., to dust, latex, glazes, or materials)? Yes / No If yes, please specify:

Does the child have asthma, eczema, or any respiratory/skin conditions? Yes / No If yes, please specify:

Any other medical conditions, medications, or special needs we should be aware of? Does the child have any injuries or restrictions that may affect participation (e.g., hand/wrist issues)? Yes / No If yes, please specify:

Consent & Liability Waiver

I, the parent/legal guardian of the child named above, hereby:

Give permission for my child to participate fully in the pottery course, including all activities such as handling clay, using tools, hand-building, decorating, and related tasks (under direct supervision).

Acknowledge that pottery involves inherent risks, including but not limited to:

1. Slips or falls on wet floors

2. Minor cuts, scrapes, or bruises from tools/equipment

3. Skin irritation or allergic reactions to wet clay, dust, or glazes

4. Muscle strain from repetitive activities

5. Confirm my child is in good health and fit to participate, and I have disclosed all relevant medical information above.

Agree to indemnify and hold harmless pottery studio 'Eden Ceramics', its staff, volunteers, and premises from any liability, claims, or actions arising from my child's participation, except where caused by gross negligence or wilful misconduct.

Authorise the instructor/studio to seek emergency medical treatment for my child if needed, and I agree to cover any associated costs.

(Photo/Video Consent) Grant permission for photos or videos of my child during the class to be used for promotional purposes (website, social media, flyers) by the studio.

Declaration

I have read, understood, and agree to the above terms and conditions.

Agree

Full Name (Parent/Guardian)