PARENTAL WAIVER AND CONSENT FORM
Chicago Children's Theatre and Once Upon Our Time Capsule is on a mission to get kids across Chicago to make Time Capsules that
tell the story of 2020 and 2021.
Today and years from now these Time Capsules will tell the story of superheroes. This summer, kids across Chicago will create Time Capsules of their lives during 2020-2021.
As the parent or legal guardian of the child named below, I hereby give my full consent and approval for my child to participate in Once Upon Our Time Capsule.
I acknowledge that Chicago Children's Theatre and Once Upon Our Time Capsule has my permission to use this image and statements contained therein in all forms of media. I understand that I will not be paid for the use of the video and my image and statements.
I grant Chicago Children's Theatre and Once Upon Our Time Capsule the right to use my (or my minor child’s) names, photographs, statements, quotes, testimonials, and image submissions for advertising, publicity, and promotional purposes without notification or further compensation.
I understand that Chicago Children's Theatre and Once Upon Our Time Capsule maintains the right to reproduce, reprint, distribute, perform, display, or exhibit the project for advertising, publicity, and promotional purposes on their website, at conferences, or at any other venues.
By submitting this entry, I give permission for this work to be published and displayed as part of Once Upon Our Time Capsule projects. I also transfer copyright for my entry to be used in events and publications made by the Once Upon Our Time Capsule or its designated partners.
I also guarantee that this entry is an original work and does not infringe upon the intellectual property
rights of another such as the unauthorized use of music, images, or logos.