{"id":8458,"date":"2024-11-20T11:45:53","date_gmt":"2024-11-20T16:45:53","guid":{"rendered":"https:\/\/indychinese.org\/?page_id=8458"},"modified":"2026-04-28T12:27:31","modified_gmt":"2026-04-28T16:27:31","slug":"consent-form","status":"publish","type":"page","link":"https:\/\/indychinese.org\/zh\/consent-form\/","title":{"rendered":"consent form"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"8458\" class=\"elementor elementor-8458\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e25545d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e25545d\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9910ede\" data-id=\"9910ede\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2e0d31f elementor-widget elementor-widget-spacer\" data-id=\"2e0d31f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-30bced1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"30bced1\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7875c75\" data-id=\"7875c75\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bb2501a elementor-widget elementor-widget-text-editor\" data-id=\"bb2501a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2 style=\"text-align: center;\"><b>ICCCI Chinese School<\/b><\/h2><h5>\u00a0<\/h5><h5 style=\"text-align: center;\"><b>Liability Waiver, Medical Authorization, Media Release, and Parent Duty Waiver Deposit Agreement<\/b><b><br \/><\/b><b>\u8d23\u4efb\u8c41\u514d\u3001\u533b\u7597\u6388\u6743\u3001\u8096\u50cf\u4f7f\u7528\u53ca\u5bb6\u957f\u503c\u73ed\u8c41\u514d\u62bc\u91d1\u534f\u8bae<\/b><\/h5><p>\u00a0<\/p><h5><b>1. Definitions \u5b9a\u4e49<\/b><\/h5><h5><span style=\"font-weight: 400;\">Indianapolis Chinese Community Center Inc. Chinese School\uff08\u201cICCCI Chinese School\u201d\u6216\u201c\u5b66\u6821\u201d\uff09\u5305\u62ec\u5176\u6240\u6709\u7ba1\u7406\u4eba\u5458\u3001\u8463\u4e8b\u3001\u5458\u5de5\u3001\u6559\u5e08\u3001\u5fd7\u613f\u8005\u3001\u627f\u5305\u65b9\u53ca\u6388\u6743\u4ee3\u8868\u3002<\/span><\/h5><p>\u00a0<\/p><h5><b>2. Assumption of Risk \u98ce\u9669\u627f\u62c5<\/b><\/h5><h5><span style=\"font-weight: 400;\">I understand that participation in School activities involves inherent risks, including but not limited to physical injury, illness, property damage, or other harm. I voluntarily assume all such risks for myself and\/or my child, including transportation to and from activities.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u4eba\u7406\u89e3\u53c2\u4e0e\u5b66\u6821\u6d3b\u52a8\u5b58\u5728\u56fa\u6709\u98ce\u9669\uff0c\u5305\u62ec\u4f46\u4e0d\u9650\u4e8e\u4eba\u8eab\u4f24\u5bb3\u3001\u75be\u75c5\u3001\u8d22\u4ea7\u635f\u5931\u6216\u5176\u4ed6\u98ce\u9669\u3002\u672c\u4eba\u81ea\u613f\u627f\u62c5\u672c\u4eba\u53ca\/\u6216\u672a\u6210\u5e74\u5b50\u5973\u53c2\u4e0e\u76f8\u5173\u6d3b\u52a8\uff08\u5305\u62ec\u5f80\u8fd4\u4ea4\u901a\uff09\u7684\u4e00\u5207\u98ce\u9669\u3002<\/span><\/h5><p>\u00a0<\/p><h5><b>3. Release of Liability \u8d23\u4efb\u8c41\u514d<\/b><\/h5><h5><span style=\"font-weight: 400;\">To the fullest extent permitted by Indiana law, I release, discharge, and hold harmless the School from any and all claims, liabilities, damages, or injuries arising out of participation in School activities, including those resulting from the ordinary negligence of the School.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u5728\u5370\u7b2c\u5b89\u7eb3\u5dde\u6cd5\u5f8b\u5141\u8bb8\u7684\u6700\u5927\u8303\u56f4\u5185\uff0c\u672c\u4eba\u540c\u610f\u514d\u9664\u5b66\u6821\u56e0\u53c2\u4e0e\u6d3b\u52a8\u6240\u4ea7\u751f\u7684\u4e00\u5207\u8d23\u4efb\uff0c\u5305\u62ec\u56e0\u5b66\u6821\u4e00\u822c\u8fc7\u5931\u5bfc\u81f4\u7684\u7d22\u8d54\u3001\u635f\u5bb3\u6216\u4f24\u5bb3\u3002<\/span><\/h5><p>\u00a0<\/p><h5><b>4. Indemnification \u8d54\u507f\u8d23\u4efb<\/b><\/h5><h5><span style=\"font-weight: 400;\">I agree to indemnify and hold harmless the School from any claims, damages, or expenses (including reasonable attorney\u2019s fees) arising out of participation, except to the extent caused by the School\u2019s gross negligence or willful misconduct.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u4eba\u540c\u610f\u5bf9\u56e0\u53c2\u4e0e\u6d3b\u52a8\u4ea7\u751f\u7684\u4efb\u4f55\u7d22\u8d54\u3001\u635f\u5931\u6216\u8d39\u7528\uff08\u5305\u62ec\u5408\u7406\u5f8b\u5e08\u8d39\uff09\u5bf9\u5b66\u6821\u8fdb\u884c\u8d54\u507f\u5e76\u4f7f\u5176\u514d\u8d23\uff0c\u4f46\u56e0\u5b66\u6821\u91cd\u5927\u8fc7\u5931\u6216\u6545\u610f\u4e0d\u5f53\u884c\u4e3a\u5bfc\u81f4\u7684\u9664\u5916\u3002<\/span><\/h5><p>\u00a0<\/p><h5><b>5. Medical Authorization \u533b\u7597\u6388\u6743<\/b><\/h5><h5><span style=\"font-weight: 400;\">In the event of an emergency, I authorize the School to obtain or arrange medical treatment for myself or my child. If I cannot be reached, the School may act in its reasonable discretion. I agree to assume full financial responsibility for any resulting costs.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u5728\u7d27\u6025\u60c5\u51b5\u4e0b\uff0c\u672c\u4eba\u6388\u6743\u5b66\u6821\u4e3a\u672c\u4eba\u6216\u672a\u6210\u5e74\u5b50\u5973\u5b89\u6392\u6216\u83b7\u53d6\u533b\u7597\u6551\u52a9\u3002\u5982\u65e0\u6cd5\u8054\u7cfb\u672c\u4eba\uff0c\u5b66\u6821\u53ef\u57fa\u4e8e\u5408\u7406\u5224\u65ad\u91c7\u53d6\u884c\u52a8\u3002\u76f8\u5173\u8d39\u7528\u7531\u672c\u4eba\u627f\u62c5\u3002<\/span><\/h5><p>\u00a0<\/p><h5><b>6. Photo \/ Video Release \u8096\u50cf\u4e0e\u5f71\u50cf\u6388\u6743<\/b><\/h5><h5><span style=\"font-weight: 400;\">I grant the School a worldwide, perpetual, royalty-free, non-exclusive right to photograph, record, and use my or my child\u2019s image, likeness, voice, and recordings for educational, promotional, and publicity purposes, including but not limited to websites, social media, publications, and displays.<\/span><\/h5><h5><span style=\"font-weight: 400;\">I waive any right to inspect, approve, or receive compensation arising from such use. To the fullest extent permitted by law, the School shall not be liable for unauthorized use by third parties.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u4eba\u6388\u6743\u5b66\u6821\u5728\u5168\u7403\u8303\u56f4\u5185\u6c38\u4e45\u3001\u65e0\u507f\u3001\u975e\u72ec\u5360\u6027\u4f7f\u7528\u672c\u4eba\u6216\u672a\u6210\u5e74\u5b50\u5973\u7684\u8096\u50cf\u3001\u5f71\u50cf\u3001\u58f0\u97f3\u53ca\u76f8\u5173\u8bb0\u5f55\uff0c\u7528\u4e8e\u6559\u5b66\u3001\u5ba3\u4f20\u53ca\u63a8\u5e7f\uff08\u5305\u62ec\u4f46\u4e0d\u9650\u4e8e\u7f51\u7ad9\u3001\u793e\u4ea4\u5a92\u4f53\u3001\u51fa\u7248\u7269\u53ca\u5c55\u793a\u7b49\uff09\u3002<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u4eba\u653e\u5f03\u5bf9\u4e0a\u8ff0\u4f7f\u7528\u7684\u5ba1\u67e5\u6743\u53ca\u83b7\u53d6\u62a5\u916c\u7684\u6743\u5229\u3002\u5728\u6cd5\u5f8b\u5141\u8bb8\u8303\u56f4\u5185\uff0c\u5b66\u6821\u4e0d\u5bf9\u7b2c\u4e09\u65b9\u672a\u7ecf\u6388\u6743\u7684\u4f7f\u7528\u627f\u62c5\u8d23\u4efb\u3002<\/span><\/h5><p>\u00a0<\/p><h5><b>7. Parent Duty Waiver Deposit \u5bb6\u957f\u503c\u73ed\u8c41\u514d\u62bc\u91d1\u6761\u6b3e<\/b><\/h5><h5><span style=\"font-weight: 400;\">The School encourages parent participation in volunteer duties (\u201cParent Duty\u201d) to support school operations.<\/span><\/h5><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">A <\/span><b>$50 deposit<\/b><span style=\"font-weight: 400;\"> is required for families who choose to waive Parent Duty obligations.<\/span><\/h5><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">This deposit serves as a <\/span><b>Parent Duty waiver fee<\/b><span style=\"font-weight: 400;\"> and is <\/span><b>non-refundable<\/b><span style=\"font-weight: 400;\">.<\/span><\/h5><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">Families who fulfill assigned Parent Duty responsibilities may not be required to pay this deposit, or may receive a refund if previously paid (subject to School policy).<\/span><\/h5><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">Failure to fulfill agreed Parent Duty obligations, if selected, will result in forfeiture of the deposit.<\/span><\/h5><\/li><\/ul><h5><span style=\"font-weight: 400;\">\u5b66\u6821\u9f13\u52b1\u5bb6\u957f\u53c2\u4e0e\u5fd7\u613f\u503c\u73ed\uff08\u201c\u5bb6\u957f\u503c\u73ed\u201d\uff09\u4ee5\u652f\u6301\u5b66\u6821\u8fd0\u8425\u3002<\/span><\/h5><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">\u9009\u62e9\u4e0d\u53c2\u4e0e\u5bb6\u957f\u503c\u73ed\u7684\u5bb6\u5ead\u9700\u652f\u4ed8 <\/span><b>$50\u62bc\u91d1<\/b><\/h5><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">\u8be5\u62bc\u91d1\u4f5c\u4e3a<\/span><b>\u5bb6\u957f\u503c\u73ed\u8c41\u514d\u8d39\u7528<\/b><span style=\"font-weight: 400;\">\uff0c<\/span><b>\u4e0d\u4e88\u9000\u8fd8<\/b><\/h5><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">\u5982\u5bb6\u5ead\u5c65\u884c\u5bb6\u957f\u503c\u73ed\u4e49\u52a1\uff0c\u5219\u65e0\u9700\u652f\u4ed8\u62bc\u91d1\u6216\u53ef\u6839\u636e\u5b66\u6821\u653f\u7b56\u9000\u8fd8\u5df2\u7f34\u62bc\u91d1<\/span><\/h5><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><h5><span style=\"font-weight: 400;\">\u5982\u5df2\u9009\u62e9\u53c2\u4e0e\u4f46\u672a\u5c65\u884c\u503c\u73ed\u4e49\u52a1\uff0c\u62bc\u91d1\u5c06\u88ab\u6ca1\u6536<\/span><\/h5><\/li><\/ul><h5>\u00a0<\/h5><h5><b>8. Compliance with Policies \u9075\u5b88\u89c4\u5b9a<\/b><\/h5><h5><span style=\"font-weight: 400;\">I agree to comply with all School policies, rules, and regulations. Failure to comply may result in disciplinary action, including removal from programs or activities.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u4eba\u540c\u610f\u9075\u5b88\u5b66\u6821\u7684\u5404\u9879\u89c4\u7ae0\u5236\u5ea6\u3002\u5982\u8fdd\u53cd\u89c4\u5b9a\uff0c\u53ef\u80fd\u9762\u4e34\u7eaa\u5f8b\u5904\u5206\uff0c\u5305\u62ec\u53d6\u6d88\u53c2\u4e0e\u8d44\u683c\u3002<\/span><\/h5><h5>\u00a0<\/h5><h5><b>9. Minors \u672a\u6210\u5e74\u4eba\u6761\u6b3e<\/b><\/h5><h5><span style=\"font-weight: 400;\">I certify that I am the parent or legal guardian of the minor participant and have full legal authority to execute this Agreement on behalf of the minor.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u4eba\u786e\u8ba4\u4f5c\u4e3a\u672a\u6210\u5e74\u53c2\u4e0e\u8005\u7684\u6cd5\u5b9a\u76d1\u62a4\u4eba\uff0c\u5177\u6709\u4ee3\u8868\u5176\u7b7e\u7f72\u672c\u534f\u8bae\u7684\u5b8c\u5168\u6cd5\u5f8b\u6743\u9650\u3002<\/span><\/h5><h5>\u00a0<\/h5><h5><b>10. Governing Law \u9002\u7528\u6cd5\u5f8b<\/b><\/h5><h5><span style=\"font-weight: 400;\">This Agreement shall be governed by and construed in accordance with the laws of the State of Indiana.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u534f\u8bae\u53d7\u7f8e\u56fd\u5370\u7b2c\u5b89\u7eb3\u5dde\u6cd5\u5f8b\u7ba1\u8f96\u5e76\u4f9d\u5176\u89e3\u91ca\u3002<\/span><\/h5><h5>\u00a0<\/h5><h5><b>11. Acknowledgment \u786e\u8ba4<\/b><\/h5><h5><span style=\"font-weight: 400;\">I acknowledge that I have read, understood, and voluntarily agree to all terms of this Agreement.<\/span><\/h5><h5><span style=\"font-weight: 400;\">\u672c\u4eba\u786e\u8ba4\u5df2\u9605\u8bfb\u3001\u7406\u89e3\u5e76\u81ea\u613f\u540c\u610f\u672c\u534f\u8bae\u7684\u5168\u90e8\u6761\u6b3e\u3002<\/span><\/h5><h5>\u00a0<\/h5><h5><b>Agreement Confirmation\u00a0<\/b><\/h5><h5><span style=\"font-weight: 400;\">I agree to the Liability Waiver, Medical Authorization, Media Release, and Parent Duty Waiver Deposit terms above<\/span><span style=\"font-weight: 400;\"><br \/><\/span><span style=\"font-weight: 400;\">\u672c\u4eba\u540c\u610f\u4e0a\u8ff0\u8d23\u4efb\u8c41\u514d\u3001\u533b\u7597\u6388\u6743\u3001\u8096\u50cf\u4f7f\u7528\u53ca\u5bb6\u957f\u503c\u73ed\u8c41\u514d\u62bc\u91d1\u534f\u8bae\u6761\u6b3e<\/span><\/h5><h5>\u00a0<\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>ICCCI Chinese School \u00a0 Liability Waiver, Medical Authorization, Media Release, and Parent Duty Waiver Deposit Agreement\u8d23\u4efb\u8c41\u514d\u3001\u533b\u7597\u6388\u6743\u3001\u8096\u50cf\u4f7f\u7528\u53ca\u5bb6\u957f\u503c\u73ed\u8c41\u514d\u62bc\u91d1\u534f\u8bae \u00a0 1. Definitions \u5b9a\u4e49 Indianapolis Chinese Community Center Inc. Chinese School\uff08\u201cICCCI Chinese School\u201d\u6216\u201c\u5b66\u6821\u201d\uff09\u5305\u62ec\u5176\u6240\u6709\u7ba1\u7406\u4eba\u5458\u3001\u8463\u4e8b\u3001\u5458\u5de5\u3001\u6559\u5e08\u3001\u5fd7\u613f\u8005\u3001\u627f\u5305\u65b9\u53ca\u6388\u6743\u4ee3\u8868\u3002 \u00a0 2. Assumption of Risk \u98ce\u9669\u627f\u62c5 I understand that participation in School activities involves inherent risks, including but not limited to physical injury, illness, property damage,&hellip; <a class=\"more-link\" href=\"https:\/\/indychinese.org\/zh\/consent-form\/\">\u7ee7\u7eed\u9605\u8bfb<span class=\"screen-reader-text\">consent form<\/span><\/a><\/p>","protected":false},"author":301,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8458","page","type-page","status-publish","hentry","entry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>consent form - ICCCI-\u5370\u57ce\u534e\u590f\u6587\u5316\u4e2d\u5fc3<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/indychinese.org\/zh\/consent-form\/\" \/>\n<meta property=\"og:locale\" content=\"zh_CN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"consent form - ICCCI-\u5370\u57ce\u534e\u590f\u6587\u5316\u4e2d\u5fc3\" \/>\n<meta property=\"og:description\" content=\"ICCCI Chinese School \u00a0 Liability Waiver, Medical Authorization, Media Release, and Parent Duty Waiver Deposit Agreement\u8d23\u4efb\u8c41\u514d\u3001\u533b\u7597\u6388\u6743\u3001\u8096\u50cf\u4f7f\u7528\u53ca\u5bb6\u957f\u503c\u73ed\u8c41\u514d\u62bc\u91d1\u534f\u8bae \u00a0 1. Definitions \u5b9a\u4e49 Indianapolis Chinese Community Center Inc. Chinese School\uff08\u201cICCCI Chinese School\u201d\u6216\u201c\u5b66\u6821\u201d\uff09\u5305\u62ec\u5176\u6240\u6709\u7ba1\u7406\u4eba\u5458\u3001\u8463\u4e8b\u3001\u5458\u5de5\u3001\u6559\u5e08\u3001\u5fd7\u613f\u8005\u3001\u627f\u5305\u65b9\u53ca\u6388\u6743\u4ee3\u8868\u3002 \u00a0 2. 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