Wide Angle Youth Media Presents: TRAVELING PHOTOGRAPHY WORKSHOP APPLICATION WHAT? A free, 4-hour workshop where students will... WHO? WHERE? WHEN? Learn photography skills Take creative self portraits Be part of a traveling exhibit* This workshop can be organized for a group of 10 Baltimore City students, ages 10-20. Who Are We? Wide Angle Youth Media is a non-profit that provides Baltimore youth with media education to tell their own stories and become engaged with their communities. Wide Angle strives to make media make a difference. Your Baltimore City Public School or youth organization. 1 four hour or 2 two hour workshops can be scheduled from October-December 2015, integrated during the school day or after school. COST? wideanglemedia.org FREE!* (*The first workshop is free, and additional workshops are available at a discounted rate of $350 each.) HOW TO APPLY: 1. SCHOOLS: Complete the school application materials and distribute + collect applications for 10 student participants. If you have any questions, please contact Wide Angle Youth Media at 443-759-6700 or email moira@wideanglemedia.org. Applications are REQUIRED before the start of the workshop. 2. STUDENTS: Each student participant must complete an application (with a parent/guardian signature) and return to the program coordinator at your school. *Photographs taken from this workshop may be printed and displayed at various locations throughout Baltimore City as part of the 2016 Traveling Photography Exhibit. This program is supported by The Fund for Rebuilding Baltimore.
Traveling Photography Workshop Application School Workshop Agreement (PLEASE PRINT CLEARLY AND FILL OUT COMPLETELY) Wide Angle Youth Media (hereinafter Wide Angle ) agrees to provide a workshop as follows: School Workshop Information School Name: School Mailing Address: School Contact Person Name: School Contact Title: School Contact Phone: School Contact E- mail: Date(s): Time(s): Location: Payment Wide Angle is proud to offer you one workshop free of charge thanks to the support of the Fund for Rebuilding Baltimore. Additional workshops are available to your site at a 65% discount of $350 per workshop. Wide Angle will also be offering opportunities to display photographs from this workshop at your school as part of the Traveling Photography Exhibition, including vinyl banners. If a workshop site determines to add on additional workshops or a photo banner, you must provide Wide Angle with a K- 12 Buy purchase order. Please review cancellation terms and conditions below. Please confirm your interest in additional opportunities: o YES, I would like to schedule more workshops. o YES, I would also like to have a vinyl photo mural printed for my school for an additional $650. o YES, I would like more information when it is available. o NO, I am not interested in future opportunities to showcase student artwork. General Terms and Conditions (Please read below thoroughly.) This agreement, when properly executed, shall constitute a valid and binding agreement between the Wide Angle and (hereinafter WORKSHOP SITE ). In the event that Workshop Site cancels prior to the workshop date/time, a minimum of 24 hour notification is required. If Workshop Site cancels less than 24 hours before the workshop date/time, Wide Angle will be paid 100% of the agreed upon fee. If no fee is charged Wide Angle will require a $100 cancelation fee from the workshop site for each canceled event. If severe weather is forecast, please contact Wide Angle in advance to plan accordingly. Workshop Site reserves the right to photograph and/or videotape Wide Angle and use said images for promotional and sponsorship/fundraising purposes at its sole discretion. Wide Angle reserves the right to photograph and/or videotape Workshop Site and use said images for promotional and sponsorship/fundraising purposes at its sole discretion. Photographs created in these workshops will become property of Wide Angle Youth Media and will be displayed at their discretion and may be featured in print and web media. Sales of original work through gallery shows will support Wide Angle Youth Media's Traveling Photography Workshops. Additionally, photographs may be included in products such as postcards and calendars, the sales of which will benefit Wide Angle Youth Media. Workshop Terms and Conditions Wide Angle will provide all necessary equipment, curriculum and supplies needed to conduct this workshop. Workshop Site will secure the necessary and required release forms prior to the start of the workshop so that student work is able to be included in the Traveling Photography Exhibition. The Workshop Site understands that this workshop is for 10 students. The workshop is capped at 10 students, and it is the responsibility of the workshop site to maintain the appropriate class size. Failure to keep class size at a 10 student maximum and/or in the appropriate age range may result in additional charges. The Workshop Site understands that this workshop is for only for students aged 10-20 years old and it is the responsibility of the workshop site to maintain the appropriate age range in the classroom. The Workshop Site will ensure that all student participants are able to attend all days of the workshop and that the students must be able to stay for the entire time period. The Workshop Site must have a staff member (preferably the classroom teacher) as a lead contact to arrange all workshop logistics. In addition, on the workshop days that staff member is present and ready to assist with the Wide Angle lesson. Wide Angle will provide a copy of the workshop curriculum with the
assigned staff member prior to the start of the program and is available to meet with that staff member for 30 minutes to discuss in detail. Wide Angle staff must be allowed a minimum of 30 minutes in the classroom to set up and break down before and after the lesson. Workshop Site must ensure that the workshop facilities must have outlets and adequate available space to complete the lesson. Liability and Insurance The Workshop Site agrees to indemnify, defend and hold harmless Wide Angle Youth Media and it s employees, board, and volunteers from any and all claims, demands, suits, and actions including attorney s fees and court costs, connected therewith, brought against Wide Angle Youth Media arising as a result of any direct or indirect, willful, or negligent act of omission of the Wide Angle, its employees, agents, or volunteers, EXCEPT for activities caused by the sole negligent act or omission of Wide Angle arising out of this contract/agreement. Wide Angle, its sponsors and the employees, representatives and agents shall not be liable for any claims, liabilities, costs and charges (including attorneys fees and costs) for injury, loss or damage to property or persons (including death) arising out of Wide Angle s activities in connection with this workshop, or any breach of representation, warranty or covenant in this agreement. Other Conditions Failure by the Workshop Site to adhere to any provision of this Agreement may result in cancellation of this agreement. Waiver of any term of this agreement or failure of Workshop Site to terminate this agreement on account of any breach by Wide Angle shall not be deemed a waiver of Workshop Site s rights to subsequently enforce any term or to terminate this contract by reason of any subsequent breach by Wide Angle. Workshop Site is responsible for any equipment that is damaged, stolen, or ruined by a student who is enrolled in the workshop. Should Wide Angle fail to fulfill any of his/her obligations pursuant to this agreement, Workshop Site may terminate this agreement upon notice to Wide Angle and (if relevant) payment shall be forfeited. Each provision of this agreement shall be deemed to be a separate, severable, and independently enforceable provision. The invalidity or breach of any provision shall not cause the invalidity or breach of the remaining provisions or of the agreement, which shall remain in full force and effect. This agreement shall in all respects be construed in accordance with and governed by the laws of the State of Maryland and subject to the jurisdiction of its courts. Furthermore, the parties hereto agree that any suits or actions brought by either party against the other shall be in a court of competent jurisdiction in Baltimore City. This agreement, together with any exhibits or attachments, contains the entire agreement between the parties and supersedes any other agreements or representations between them, whether oral or written. No provisions of this agreement may be amended, waived or modified except by a written agreement signed by both parties. This Agreement may be transmitted in electronic format and shall not be denied legal effect solely because it was formed or transmitted, in whole or in part, by electronic record. However, this Agreement must then remain capable of being retained and accurately reproduced, from time to time, by electronic record by the parties to this Agreement and all other persons or entities required by law. An electronically transmitted signature to this Agreement will be deemed an acceptable original for purposes of consummating this Agreement and binding the parties providing such electronic signatures. In signing this agreement, the Workshop Site accepts the terms outlined above. PLEASE PRINT or COPY TWO (2) COPIES, SIGN AND RETURN ONE (1) TO: Julie Stovall Lauver Wide Angle Youth Media 2601 N. Howard Street, Suite #160 Baltimore, MD 21218 Julie@wideanglemedia.org, fax: 410-752- 7053 Printed Name of Authorized School Representative Signature of Authorized School Representative Date Signed Printed Name of Wide Angle Representative Signature of Wide Angle Representative Date Signed A FULLY EXECUTED COPY WILL BE EMAILED TO YOU. Attached, please see flyer and application for student participants with space to include your school contact information and workshop date.
Wide Angle Youth Media Presents: TRAVELING PHOTOGRAPHY WORKSHOP APPLICATION WHAT? A free, 4-hour workshop where you will... WHO? WHERE? Learn photography skills Take creative self portraits Be part of a traveling exhibit* This workshop is offered to Baltimore City students, ages 10-20. Who Are We? Wide Angle Youth Media is a non-profit that provides Baltimore youth with media education to tell their own stories and become engaged with their communities. Wide Angle strives to make media make a difference. WHEN? COST? FREE!* (*The first workshop is free, and additional workshops are available at a discounted rate of $350 each for Baltimore City Public Schools.) HOW TO APPLY: Each student participant must complete an application (with a parent/guardian signature) and return to the program coordinator at your school PRIOR to the start of the workshop! Please Return To: NO LATER THAN. *Photographs taken from this workshop may be printed and displayed at various locations throughout Baltimore City as part of the 2016 Traveling Photography Exhibit. This program is supported by the Fund for Rebuilding Baltimore.
** Schools must collect this form for each participant and return to Wide Angle PRIOR to the start of the workshop. ** 2015-2016 Traveling Photography Workshop Application: Student Participant Information (PLEASE PRINT CLEARLY AND FILL OUT COMPLETELY) First Name Middle Initial Last Name Nick Name Birth Date (mm/dd/yy) Age Gender School Grade PIF Parent/Guardian Name Relation to Child Street Address Apt# City State Zip Phone Emergency Contact Name Emergency Contact Phone ( ) Demographic Information The following information is required by the program s funders and will be kept confidential. 1. Select the race that best describes your child: African American Hispanic Caucasian Hawaiian or Pacific Islander Native American Bi- Racial Multi- Racial Other 2. At school, was your child entitled to free or reduced- cost lunch last year? Yes No 3. Is your child currently homeless? Yes No Permission & Medical Release Form I, give my permission for (Parent/Guardian Name) (Youth s Name) to participate in any and all activities of Wide Angle Youth Media. I am aware that my child will learn how to use media production equipment, and have their own image and voice recorded, in the process of learning how to produce media messages, which may be distributed publicly. I understand that my child will go on supervised neighborhood walks within a ten block radius of the workshop site. On these trips my child will be filming or conducting research for their projects, and I give permission for them to participate in this activity. I understand my child will be exposed to certain risks that by nature and location of these activities cannot be controlled. I agree to release and forever discharge Wide Angle Youth Media, their boards of directors, volunteers, employees and agents from any and all liability, and claims in any way connected with my child s participation. I grant Wide Angle Youth Media permission to gather my child s average daily attendance data for research purposes from Baltimore City Public Schools that may be shared with third parties. I grant Wide Angle Youth Media permission to copyright and use, reuse, publish, and re-publish the image, voice, and likeness of my child, as well as any writing, drawing, or other media produced by my child, for inclusion in any media produced by Wide Angle Youth Media, and permit Wide Angle Youth Media to use materials for said media for education, sales, promotion, and other related purpose in print, video, on the web, and all media. I hereby assign all rights to all materials created by my child hereunder to Wide Angle Youth Media, but I understand that my child may use such materials for his/her resume reel or for college or job application purposes. I waive any and all rights to approve the final product, limit its distribution or receive any proceeds resulting from its distribution. I agree that my child/teen has my permission to participate in all sessions and field activities. In case of emergency, I hereby request and authorize any physician, hospital and healthcare provider to provide medical treatment promptly for my child whether or not I am contacted and informed. Parent/Guardian's Printed Name Parent/Guardian's Signature Date Name of Insurance Company Please list any allergies or medical conditions we should be aware of: