BEE WELL: Mental Health Awareness Window Paint-a-thon

	May 1, 2027
	10:00am to 1:00pm
	B'ville 4 Corners and Surrounding Areas
	Lysander Parks and Recreation Terms and Conditions301.36 KB

REGISTRATION FORM BELOW

Our annual BEE WELL Mental Wellness Window Paint-A-Thon is a go! This event serves as a launch to Mental Health Awareness Month that is observed and celebrated each May! It is important to take time to spread the messaging of mental wellness in our community and work to break the stigma surrounding this very important topic. Much like we work to take care of our physical health, we must also do the same for our emotional and mental well-being. This event is a collaboration with the BCSD Mental Wellness Committee and the Town of Lysander Parks and Recreation.

This is a FREE PROGRAM. Please submit your registration form by Friday, April 23rd, 2027, to ensure your spot. Space is limited, so please register ahead of time.

We can't wait to see the artwork our community creates! ❤️

Permission and Photo Release:
By completing this form, I give my child permission to paint in the BEE WELL Mental Wellness Paint-A-Thon and also give permission for my child’s picture to be used in any newspaper, magazine, or web publication article concerning the event.
Please contact us at 315-529-6546 if you do not want your child’s picture used in any form of publication.

Supervision Notice + Event Policies:
At some point during the week before the event, you will be sent an email with a reminder of the rules and a list of supplies you should bring. Some of that information is featured below.

I understand that being able to partake in this event and be allowed to paint the windows of the businesses within the Village of Baldwinsville is a privilege.
I or another adult agree to supervise and remain WITH my child during the event.
All pictures painted should promote positive mental wellness and well-being.
We are responsible for bringing cups, plates etc. to hold paint and paint brushes to paint windows. **PAINT WILL BE PROVIDED.**
We will protect business window frames by using necessary safety measures (painters tape, newspaper drop cloths etc.)
We are responsible for the clean-up of any paint and supplies that are used the day of the event.
We will only paint at our assigned window number.

Thank you for your participation and BEE WELL!

Event Date: Saturday May 1, 2027

Event Time: 10:00am- 1:00pm
Event Address: B'Ville Village 4 Corners + Surrounding Areas
For Questions: Contact us at: programs@townoflysander.org, JennaWolken@bville.org, GReimann@bville.org

REGISTRATION FORM

Use the form below to register for the 2027 Mental Health Awareness Window Paint-A-Thon. Please reach out to programs@townoflysander.org OR 315-635-5999 with any questions or concerns.

Participants

Please enter the names of the painters below. If they would like to share a window, please specify in the text box at the end of the form.

Participants
First Name Last Name DOB

Parent/Guardian Name

Parent/Guardian Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Cell Phone

Additional Parent/Guardians

Secondary Guardians are Approved For Pick-Up, OR In The Event Of An Emergency

Additional Parent/Guardians
Guardian Name Guardian Cell Phone

Would you like to share a window with anyone?

Please write name below.

Would you a window placement near a specific person?

Please write name below.

Have you participated in our annual Halloween Window Painting before?

Please answer yes or no.

Do you have any other comments or requests?

We will do our best to accommodate requests; however, we cannot guarantee anything. Thank you for your understanding.

PHOTO RELEASE: Photos taken for publicity purposes may be used on the Town Web Site, our Facebook pages, in local newspapers or in our brochures, unless otherwise requested by the parent/guardian or participant.

LIABILITY WAIVER AND RELEASE: As the participant, or the parent or legal guardian of the above-named participant in consideration of the risk of injury that exists while participating in the above named Recreation Program (hereinafter the “Activity”); and in consideration of my desire to participate in said Activity and being given the right to participate in same; I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, “Releasor,” “I” or “me”, which terms
shall also include Releasor’s parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and herby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity; and I hereby release and forever discharge the TOWN OF LYSANDER, located at 8220 Loop Road, Baldwinsville, New York 13027, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns now have, ever have had, or may in the future have, (collectively “Releasees”), for claims arising under any federal, state, or local statute or the common law, including but not limited to theories based upon contract, fraud, malpractice, breach of fiduciary duty, defamation, negligence, or any other tort law from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity. With my signature below, I hereby certify that I am the participant, or the parent or guardian of the above-named participant, have read and fully understand the content of this agreement and do hereby give my consent without reservation to the foregoing as myself, or on behalf of the above-named individual within my care.

Parent/Guardian Digital Signature

Please type your name if you agree with the previous terms.

Date of Acceptance

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