CONSENT AND RELEASE: PLEASE READ CAREFULLY BEFORE PROCEEDING!
This Consent, Release and Waiver of Liability (the "Release") is hereby executed on the date written below by the undersigned participant or volunteer (the "Participant") in favor of the American Cancer Society, Inc., its affiliated divisions and entities, all host facilities, subcontractors, and sponsors, including in each case, without limitation, their directors, officers, employees, volunteers, and agents (collectively "ACS"). The Participant desires to engage in certain fundraising activities and/or events with ACS during the current calendar year, including but not limited to Relay for Life® and/or Making Strides Against Breast Cancer® (the "Activities") and understands that his/her participation in these Activities may include camping, picnicking, walking, jogging, running, bicycling, swimming, water plunging, golfing, exercising, climbing, or other recreational or team sports, and any other physical activity reasonably anticipated to be performed by Participant as a part of or in any way associated with ACS Activities. The Participant acknowledges that he/she derives personal satisfaction and a benefit by virtue of his/her participation with ACS and/or performing the Activities discussed above, and Participant willingly engages in these Activities.
The Participant hereby freely, voluntarily, and without influence from anyone or duress of any kind executes this Release and consents and agrees to each of the following:
RELEASE AND WAIVER. THE UNDERSIGNED PARTICIPANT HEREBY RELEASES, WAIVES AND FOREVER DISCHARGES ANY AND ALL LIABILITY, CLAIMS, AND DEMANDS OF WHATEVER KIND OR NATURE AGAINST ACS, INCLUDING ITS SUCCESSORS AND ASSIGNS, EITHER IN LAW OR IN EQUITY, TO THE FULLEST EXTENT PERMISSIBLE BY LAW, INCLUDING BUT NOT LIMITED TO THE NEGLIGENCE, FAULT OR MISCONDUCT OF ANY KIND ON THE PART OF ACS FOR DAMAGES OR CAUSES OF ACTION, INCLUDING BUT NOT LIMITED TO DEATH, BODILY OR PERSONAL INJURY, ILLNESS, ECONOMIC LOSS OR OUT OF POCKET EXPENSES, OR LOSS OR DAMAGE TO PROPERTY, WHICH PARTICIPANT, HIS/HER HEIRS, ASSIGNEES, NEXT OF KIN AND/OR LEGALLY APPOINTED OR DESIGNATED REPRESENTATIVES, MAY HAVE OR WHICH MAY HEREINAFTER ACCRUE ON THEIR BEHALF, WHICH ARISE OR MAY HEREAFTER ARISE FROM THE PERFORMANCE OF PARTICIPANT'S ACTIVITIES AND/OR PARTICIPATION WITH ACS ACTIVITIES.
EFFECTIVE DURATION. I UNDERSTAND AND AGREE THAT THIS RELEASE AND WAIVER WILL APPLY TO AND GOVERN MY PARTICIPATION IN ANY AND ALL ACS ACTIVITIES AND/OR EVENTS DURING THE CURRENT CALENDAR YEAR. FURTHER, I FULLY INTEND FOR THIS RELEASE AND WAIVER TO BE EFFECTIVE FOR THE DURATION OF THE CURRENT CALENDAR YEAR.
ASSUMPTION OF THE RISK. The Participant understands that the Activities include work that may be hazardous to the Participant, including but not limited to camping, picnicking, walking, jogging, and running, and any other activities reasonably anticipated to be performed by Participant as a part of or in any way associated with ACS Activities, and hereby knowingly assumes the risk of injury, harm and loss associated with the Activities and participation with ACS, including any injury, harm and loss caused by the negligence, fault or misconduct of any kind on the part of ACS.
MEDICAL TREATMENT. Participant does hereby release and forever discharge ACS from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Participant's Activities with ACS. Participant hereby grants permission to ACS to render preventative or first-aid assistance or seek treatment or medical care that seems reasonably necessary, including hospitalization, for Participant's health and well-being. Participant agrees that ACS may give out any and all medical information, including Participant's personal health information ("PHI"), to any physicians, hospitals, ambulance companies, or any other health care provider in the event of an emergency and/or hospitalization, as reasonably necessary for purposes related to Participant's treatment.
IMAGE RELEASE. Participant does hereby grant and convey unto ACS all right, title, and interest in any and all photographic images and video or audio recordings made by ACS during the Participant's Activities with ACS, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings. Participant hereby releases, discharges and agrees to save harmless ACS, its legal representatives or assigns, and all persons acting under its permission or upon its authority or for whom it is acting, from any liability by virtue of any publication of Participant's likeness, including, without limitation, claims for libel or invasion of privacy.
THE FOLLOWING MUST ALSO BE COMPLETED BY PARENT OR GUARDIAN IF PARTICIPANT IS A MINOR CHILD UNDER 18 YEARS OF AGE:
In consideration of the minor child's (under 18 years of age) (Minor Participant) participation in any ACS Activities or youth events such as Relay Recess or Field Day, the undersigned in his/her capacity as Minor Participant's parent or guardian, hereby (a) give permission for the Minor Participant, who is my child or ward, to participate voluntarily in ACS Activities and/or perform the Activities referenced in the Release, and (b) understand that this Release forever releases, waives and discharges any and all liability, claims, and demands of whatever kind or nature against ACS and Released Parties, including ACS's successors and assigns, either in law or in equity, to the fullest extent permissible by law, including but not limited to the negligence, fault or misconduct of any kind on the part of ACS for damages or causes of action, including but not limited to death, bodily or personal injury, illness, economic loss or out of pocket expenses, or loss or damage to property, which Minor Participant, his/her heirs, assignees, next of kin and/or legally appointed or designated representatives, may have or which may hereinafter accrue on their behalf, which arise or may hereafter arise from the performance of Minor Participant's Activities and/or his/her participation in ACS Activities.
I also acknowledge reading and understanding all of the terms and conditions set forth in the Release signed by my child or ward, and consent and agree to each and every term and condition contained in the Release.
Direct Privacy Notice to Parents of Children under 13 Years of Age
Checking the box below, and completing this registration does prove that you are consenting to the waiver & release of certain legal rights as set forth in this release and waiver of liability agreement.