Glass Experience Release Form

This release form must be on file to utilize facilities at Liquid Light Glass

THIS FORM IS ONLY TO BE SUBMITTED AFTER REGISTERING FOR A CLASS WITH A DEPOSIT

Instructions:

Please only fill out once you have first read through our class information page AND have booked your class by contacting us here

Each adult participant must fill out this form and agree to the release individually.

Please have one representative for your party list the names of all participants in your group so we know who is together.

My Class Has Been Scheduled and Deposit Paid

Please see above instructions if you have not yet scheduled your class

Check to Confirm

Date of Scheduled Class

MM

DD

YYYY

Time of Scheduled Class

Hour

Minute

Second

Participant's Name

First Name

Last Name

More Participants?

Please fill out if you are the group representative

Click to add more names

Are Any Participants Under Age 18?

No

Yes

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Release

By checking the box below I certify that I, the participant, am 18 years of age or older; or that I am the legal parent/guardian of a participant under the age of 18, and I hereby agree that in consideration of Liquid Light Glass allowing me to use their facilities, materials and equipment, that I hereby remise, release now and forever, Liquid Light Glass, Baca Street Studios and/or its affiliates, subsidiaries and assigns of any and all claims, damages and injuries to myself, to my property, which arise out of or in any way related to any activities on the premises of Liquid Light Glass, and/or Baca Street Studios, from any such claims or allegations which I might now have, may have, or any of my heirs, successors or assigns.

I Agree to the Terms of this Release