Chicago Glass Collective

SUMMER GLASS INTENSIVE FORMS

Please read and sign at the bottom prior to the first day of camp.

MEDICAL INFORMATION & PARTICPATION AGREEMENT

I am signing below stating that I agree to this Participation Agreement and Release and Waiver of Liability (“Release”) in exchange for the opportunity to use the facilities, services, equipment and premises of CGC located at 1770 W. Berteau Suites 203B and 111 and/or participate in any program, class, or activity (the “Programs”) provided by Chicago Glass Collective, LLC (“CGC”).

This Release releases CGC, existing under the laws of the State of Illinois, and each of its current or future parents, subsidiaries, divisions, affiliates, predecessors, successors, and assigns and all of their current, former and future agents, employees, officers, directors, attorneys, member, partners, owners, representatives, predecessors, successors and assigns (collectively referred to as “CGC Releasees”).

If I am signing on behalf of a minor child (under the age of 18), I represent that I am the minor child’s parent or legal guardian. I understand that I and/or the minor child for whom I am signing are each and collectively a “Participant” under this Agreement.

I understand that the scope of Participant's relationship with CGC is limited to a guest, invited to participate in the Programs. I understand that participation in the Programs involves risks, including but not limited to, personal injury and property loss arising from contact with hot glass, heated instruments, industrial tools and equipment, broken glass, and with a variety of studio conditions and skillsets. I also understand that Participant may be exposed to risks inherent to living and working in a community in CGC, where Participant may be exposed to environmental, food or other allergens, including but not limited to dust, smoke and other environment irritants inherent to glass working.

I understand this Release will apply for each and every day any Participant uses CGC or participates in Programs.

I agree to the following duties and responsibilities:

1. I acknowledge and affirm that Participant is voluntarily agreeing to participate in glass working or the Programs with knowledge of the risks and dangers involved, and I agree to accept full responsibility for the risks and dangers.

2. I agree that Participant will observe all safety guidelines, including any guidance and/or requirements imposed by CGC, the Center for Disease Control and Prevention, State of Illinois and/or local health authorities.

3. I agree that Participant will use the studios and facilities according to the rules and instructions of CGC.

4. I agree that Participant will wear safety glasses and other personal protective equipment required by CGC while in all studios.

5. I agree that Participant will exercise extreme caution to prevent injury and illness of ourselves and/or others.

6. I agree that Participant is responsible for Participant's care and safety while participating in the Programs and/or while in CGC for any reason.

7. I agree that Participant is responsible for Participant’s property while participating in Programs and/or while in CGC for any reason, including for the care of Participant’s tools, work in progress, and/or works of art.

8. If entering into this Release on behalf of a minor child for whom I am the parent or legal guardian, I understand that I am responsible for the health and safety of the minor child at all times. I understand that I am responsible for ensuring that the minor child is supervised at all times while at CGC and when the minor child is not participating in a Program.

9. I agree that Participant will respect and act in conformity with CGC’s commitment to inclusion and equal opportunity. I understand that CGC celebrates diversity and is committed to creating an inclusive environment for all. I understand that CGC welcomes and respects everyone regardless of age, race, ethnicity, religion, sexual orientation, gender identity of expression, national origin, veteran, disability, or socioeconomic status, and any other status protected by local, state, or federal law. I understand that CGC is committed to providing an environment free of discrimination and harassment.

10. I acknowledge that CGC may, in its own discretion, expel Participant from participation in any Program or expel Participant from CGC for any reason permitted by law. I understand and agree that if Participant is expelled for violating any obligation under this Release and/or acting in any way that is adverse to CGC's’ policies, practices or principles, Participant will not be entitled to any refund of any fees paid to CGC for the program or activity from which Participant is expelled.

I agree to the following releases and waivers:

11. Waiver and Release: I, on behalf of myself, Participant and our estates, release and forever discharge and hold harmless CGC, from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from Participant’s voluntary participation in any Programs, except for claims arising from CGC’s intentional wrongdoing, gross negligence or fraudulent conduct. I understand and acknowledge that this Release discharges CGC from any liability or claim that Participant may have against CGC with respect to any personal injury, property damage, disability, death, sickness or disease incurred by Participant, Participant’s family members, dependents, or guests, including minors, however occurring, and including, but not limited to the negligence of CGC Releasees. I understand that Participant will be solely responsible for any loss or damage, including personal injury, property damage, disability, death, sickness or disease sustained by any Participant from the use of CGC and/or participation in Programs. I further agree, on behalf of myself and any and all legal successors and proxies, to release and HEREBY DO RELEASE, WAIVE AND COVENANT NOT TO SUE CGC Releasees from any causes of action, claims, suits, costs and expenses (including attorneys’ fees), fines, penalties, liabilities or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I and any and all legal successors and proxies may have, now or in the future, against CGC Releasees on account of personal injury, property damage, disability, death, sickness, diseases or accident of any kind (collectively, “Claims”), arising out of or in any way related to the use of the CGC and/or participation in Programs by any Participant whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of CGC Releasees.

12. Insurance: I understand that CGC does not assume any responsibility for or obligation to provide Participant with financial or other assistance, including but not limited to medical, health, or disability payments, benefits or insurance. I expressly waive any such claim for compensation or liability on the part of CGC beyond what may be offered freely by CGC in the event of injury or medical expenses incurred by Participant.

13. Medical Treatment: I hereby release and forever discharge CGC from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during Participant's participation in any Program. By signing this Release, I am certifying that Participant is medically fit to perform the types of physical activities associated with the Program. If there is any questions regarding Participant’s medical fitness, I agree to seek medical consultation before Participant participates in any Program.

14. Assumption of Risk: I understand that use of the Studio and Programs carry certain risks, inherent and otherwise, including but not limited to: (1) equipment failure or improper use, (2) the urban and industrial environment, (3) moving in hallways and stairwells from floor to floor, (4) strenuous activity, (5) negligence of CGC or Program operator, instructor, or other Participants. I understand that these risks may result in: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and/or (5) sickness or disease including, without limitation, COVID-19. I, for myself and any minor Participant, voluntarily, irrevocably and unconditionally ACCEPT AND ASSUME FULL RESPONSIBILITY FOR ALL RISKS as well as any and all other risks of the use of CGC and/or participation in Programs, including risks and outcomes not described in this document, regardless of whether they are foreseen or unforeseen. If signing on behalf of myself, I agree that I am responsible for evaluating whether I believe CGC and/or Programs that I or other Participants wish to use or participate in are safe. If I do not believe CGC or Programs are safe, I agree that neither I nor any Participant will use or participate in them. I understand that, should I choose to accept the risks and use and/or participate in CGC or Programs, I am responsible for following all available instructions and signage. I also understand that no user is to rely on following any instructions or signage provided by CGC for safety, as they do not guarantee safety. Any instructions or signage are intended only to help reduce accidents. I understand that CGC is not liable for any injury or damage that may arise from adhering to instructions or signage. Finally, I understand that CGC is not responsible for enforcing instructions or signage, nor for inconsistent enforcement.

To the extent this Release pertains to use of CGC only (not to include participation in official Programs), I understand that CGC has not inspected the location for any outing. I agree to accept CGC AS-IS AND WITH NO WARRANTIES, express or implied, WITH ALL FAULTS AND WITH NO REPRESENTATION OR WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING WARRANTY OF FITNESS FOR THE INTENDED USE. CGC expresses no comment regarding the safety measures or operating practices employed by any other entities or third parties that provide services and/or equipment at CGC or for Programs for any Participant.

If signing on behalf of a minor child for whom I am a parent or legal guardian, I understand that I voluntary grant permission for my minor child to use CGC and/or participate in Programs despite any and all risks. I further warrant that (1) I have spoken to my child about CGC and/or Programs, (2) my child understands and appreciates the risks of using CGC and/or participating in the Programs, (3) my child understands and will follow all available instructions and signage, and (4) my child is voluntarily using CGC and/or participating in the Programs. I further understand and agree that the health and safety of my child is my sole responsibility. I understand that it is my responsibility, as the child’s parent or legal guardian, to ensure that my child is supervised at all times while in CGC.

15. Indemnification: In further consideration of the use of CGC and/or participation in Programs, I agree on behalf of myself and my estate to INDEMNIFY, DEFEND AND HOLD HARMLESS CGC Releasees from any and all Claims arising out of or in any way related to the use of CGC and/ or participation in Programs by any Participant. The terms of this agreement shall serve as a release and indemnity agreement for myself and my estate.

16. Other: I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Illinois, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Illinois. I agree that in the event that any clause or provision of this Release is deemed invalid, such provisions shall be modified and if such modification is not possible, severed from the Release, and the enforceability of the remaining provisions of this Release shall not be affected.

17. I fully understand this document, and I am aware that this is a release of liability and that I am GIVING UP MY RIGHT TO SUE OR ANY CGC (Chicago Glass Collective, LLC) RELEASEES for any injury or loss suffered by Participant as a result of Participant’s participation in any Program or use of CGC, except as provided herein.

By signing below I agree that I have read and understand this agreement.