(415) 482-0176

Little Production's / Self Reflections, Inc.

Little Production's / Self Reflections, Inc. Little Production's / Self Reflections, Inc. Little Production's / Self Reflections, Inc.

Little Production's / Self Reflections, Inc.

Little Production's / Self Reflections, Inc. Little Production's / Self Reflections, Inc. Little Production's / Self Reflections, Inc.
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      • WORKSHOPS
      • FOSTER & ADOPTION HELP!
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      • Little's SHOP of PRODUCT
      • PUBLIC SPEAKING
      • CLASSES / WORKSHOPS
      • WORKSHOP REGISTRATION

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    • WORKSHOPS
    • FOSTER & ADOPTION HELP!
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    • PUBLIC SPEAKING
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    • WORKSHOP REGISTRATION

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Please fill out this release form

Then submit it so you can take part in our workshop.

RELEASE AGREEMENT

1. I will follow the schedule and abide by the rules and regulations as set forth by Little Productions while participating in special events.


2. I will not hold Little Productions responsible nor does Little Productions assume any responsibility, for loss of or damage to my property.


3. I will not hold Little Productions responsible for any injury that may occur to me in conjunction with this event.


4. I grant permission to Little Productions or a Representative of Little Productions to render or seek emergency first aid treatment to me, if it appears necessary to such person.


5. I release Little Productions, its officers, members, agents, employees, licensees, independent contractors, and/or assignees from any and all claims, demands, liabilities, action or suit, costs and expenses whatsoever known or unknown arising out of or in any way connected with Little Productions.


6. I hereby irrevocably consent to and authorize the use and reproduction by you, or anyone authorized by you, of any and all recordings whether transferred to videotape, film, slides, photographs, musical arrangements or any media voice without additional compensation. I consent to the use of my name, likeness, voice and image to be used at your discretion for any or all of said productions forever and throughout the world, also without additional compensation unless otherwise stated and agreed upon by contract. This includes, without limitation, the right to edit, mix or duplicate and to use or reuse said recordings in whole or in part, as Little Productions may desire.


I affirm that I have read and understand each and every word of the foregoing and have received and will retain a copy of this release agreement.


By typing my name below, I understand and agree to this Agreement.

I, parent, and/or legal guardian, of the child listed below do hereby consent to the above listed conditions of participation and grant permission to all the foregoing.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

** Your typed signature acknowleges that you agree to these terms.

*** You will be asked to sign this form, in person, when you drop off your child at the workshop.


We will be in contact with you to confirm receipt of this information.

THANK YOU!


_____________________________

Little Productions, Inc with Barbara Davis

San Rafael, CA 94901, USA

(415) 482-0176

Little Productions, Inc with Barbara Davis

San Rafael, CA 94901, USA

(415) 482-0176