PARNETAL CONSENT

Smoke and Mirrors is an improvisational theater group that runs out of the Saint Johns United Church of Christ in Evanston, IL but is not directly affiliated with them. We meet every second and fourth Saturday night of the month form 7pm to 1:30am. The content of Smoke and Mirrors does involve some adult themes and language. Additional information on our activities and story is available on our web site http://balls2000.home.comcast.net or by e-mailing us at SmokeandMirrors-ST@hotmail.com.

I, the minor’s parent and/or legal guardian, understand the nature of the minor's intended use of the Premises and the minor’s experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, covenant not to sue and agree to indemnify and save and hold harmless each of the Released Parties from all liability, claims, demands, losses or damages on the minor’s account caused or alleged to be caused in whole or in part by the minor's use of the Premises, and further agree that if, despite this release, I, the minor, or anyone on the minor’s behalf, makes any claim against any of the Released Parties, I will indemnify, save and hold harmless each of the Released Parties from any litigation expenses (including attorneys’ fees), losses, liability, damages, or costs any of said parties may incur as the result of any such claim.

Date: _______________________, 20____

Printed Name of Parent/Guardian: _______________________________________________________
Telephone: (_____) _____ - _______

Parent/Guardian Signature: _____________________________________________________________