Event Registration

Program Participant Consent/Release:

Use of Art Therapy Work Products &

Engage in Art Therapy & Confidentiality

I, as a program participant, hereby acknowledge that during the duration of the Twistshop program I will be sharing, and be a witness to the sharing of personal information of participants. I will respect the privacy and confidentiality of the participants within the workshop/webinar and not disclose any individual’s private information. It is my understanding that Twist Out Cancer will not reveal personal contact information or display my artwork for reasons outside of promoting/ sharing the mission of Twist Out Cancer.

I further give Twist Out Cancer permission to interview/photograph artwork created by me in a professional setting for the purpose of future marketing or education on the therapeutic use of art therapy. It is my understanding that my full legal name will not be revealed in any presentation or display of my artwork without my permission.

I release the contracted program facilitator, Twist Out Cancer, and Bernard Zell Anshe Emet Day School from any and all responsibility and liability which may result from my participation. 

By completing this online registration form, I agree to the terms outlined above. I permit the minor listed above to participate in the program and to be supervised by Bernard Zell staff if the minor is unaccompanied by a parent or guardian.