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Too Good for Drugs & Violence 2023

Consent & Disclosure Form


GENERAL CONSENT:  By signing below, I hereby agree to release and hold harmless Pathway to the Future Learning Center, Inc. DBA Pathway Resource Center, Inc. and its affiliates Flaherty & Collins Inc, Amber Woods Apartments and Miller Transportation, employees, officers, volunteers, directors and contractors from and against all liability as a result of my child’s participation in all approved Pathway Resource Center, Inc. programming and/or events. Moreover, as the parent(s) and/or legal guardian(s) of the above referenced youth, I agree to indemnify and Pathway Resource Center, Inc. and its agents, employees, individual staff and volunteer harmless against any and all claims, liabilities, losses, damages, or expenses of any kind, including reasonable attorney fees, sustained as a result of participation in any and all programs and/or events held by Pathway Resource Center, Inc.

MEDIA RELEASE: I grant to Pathway Resource Center, Inc. the exclusive right to use my child's interview/photograph/video or film likeness in media and promotional materials. I authorize others to use all or any part of my child’s interview/photograph/video in related media such as books, magazines, journals, pamphlets, electronic (internet) and other written and video formats. The undersigned also releases Pathway Resource Center, Inc. and its directors, its members, trustees, founders, officers, employees, partners, and agents, from any and all claims, demands, causes of action and suits, including by not limited to, claims for invasion of privacy, defamation, breach of contract or other breach of duty arising out of or in connection with the use of any interview, photograph, video or other media representations.

Thank you!

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