Peace Flags By Kids, Inc Project Parent/Guardian Consent Form Peace Flags by Kids, Inc is a community based art and self-expression project for children of all ages, who are interested in expressing their thoughts and feelings about living in peace, harmony, love understanding, tolerance, hope and sharing the resources of the planet in a beneficial way for all. The Children will be creating flags as their gift to the World. The Peace Flags will then hang up in the communities around the world, to share their message, for all to enjoy. The art mediums will consist of painting, drawing and writing. Name of Child_____________________________________________ Home Phone___________________ Grade_________________ Date of Birth_________________________ Age___________ Gender_________ Name of Child_____________________________________________ Home Phone____________________ Grade_________________ Date of Birth________________________ Age____________ Gender_________ Address________________________________________________________________________________ City________________________________________State____________________Zip Code___________ E-mail:_________________________________________________________________________________ I realize Peace Flags by Kid, Inc will keep all flags made by children and display them around the world, at public and private events. In addition, their art will also be reproduced for fundraising and charity projects to support children Worldwide. I give permission to: (Please check all below) ___ to photograph my child/ward and send me a photo. ___ to display event photos and their photos on the web page/photo gallery on the Internet. ___ to film, videotape and interview your child/ward for any Peace Flags by Kids, Inc media projects. I agree, as well as my child/ward and next of kin to allow my child/ward to participate in the Peace Flags by Kids,Inc Project and we hereby release and agree to indemnify and hold harmless Peace Flags by Kids, Inc any of its organizers, volunteers and supporters, from any and all claims which may now and hereafter arise from our child’s/ward’s participation in the Peace Flags by Kids,Inc. We have read the above and understand this release. Signature_______________________________________________________ Date___________________ Parent/Guardian Name___________________________________________ Relationship________________________ ___ Address same as Child. Address________________________________________________________________________________ City________________________________________State____________________Zip Code___________ Home Phone_____________________Cell Phone_________________Work Phone_________________ E-mail_________________________________________________________________________________ © All Rights Reserved. 2006