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UnitedHealthcare Children’s Foundation
2018 Teddy Bear 5K Run and 1 Mile Walk Event
Release Waiver & Indemnification Form


A signed form must be on file for you to participate in the UnitedHealthcare Children’s Foundation 2018 Teddy Bear 5K Run and 1 Mile Walk Event.


General Release
Participant understands that there are risks inherent in participation in the UnitedHealthcare Children’s Foundation (UHCCF) 2018 Teddy Bear 5K Run and 1 Mile Walk (Event) and associated activities to be held at Tivoli Village, (Event Site) on October 13, 2018, including but not limited to suffering from heat exhaustion, heart attack or injury from uneven terrain, all of which risks participant assumes and accepts, and waives all claims of injury to body or property against UHCCF.
Participant acknowledges that UHCCF does not assume responsibility for any injuries, death or damage resulting from these dangers, hazards or risks. I understand that UHCCF in no way represents, or acts as agent for the operation or management of any means of transportation, facilities or other suppliers of goods or services used by the participant during the Event and related activities. I further understand that UHCCF is not responsible or liable for any injury, damage, loss, accident, delay or other irregularity which may affect or be caused by any supplier of any goods or services used by, during or related to the Event and related activities.
The undersigned hereby agree to release, and hold harmless the UHCCF, its directors, officers, agents, volunteers and assignees from and against any claims, damages or liability arising from or related to the undersigned’s participation in the Event and relate events.
Knowing the risks described above, and in voluntary consideration of being permitted to participate in the Event and related activities, the undersigned participant, (and his/her parent(s) or legal guardian(s), if the participant is under the age of 18 years), do hereby execute this release waiver and indemnification for himself/herself, and his/her heirs, successors, representatives, and assigns and agrees to release, indemnify, and hold harmless UHCCF their directors, officers, agents and volunteers for and against any claim which I, the participant, my parents or legal guardian(s) or any other person may have for losses, damages or injuries arising out of or in connection with my participation in the Event and related recreational and educational activities.
Video and Photo Release
During the Event and related activities, the undersigned grants permission to UHCCF to record my participation, appearance, image, likeness and voice on video tape, audio tape, film, photograph or in any other medium. Additionally, UHCCF or its designee may publish the same in any form of publication, including, but not limited to print, electronic, video, or Internet in furtherance of the mission of the UHCCF. The undersigned further waives any right to inspect or approve finished photographs, printed or electronic matter that may be used in conjunction with such publication now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to such use.
The undersigned hereby agree to release, and hold harmless the UHCCF, its directors, officers, agents, volunteers and assignees from and against any claims, damages or liability arising from or related to the use of the photographs.
The undersigned has read this Release, Waiver and Indemnification before signing below and fully understands the contents meaning and impact of this document.

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Location Release and Consent

For good and valuable consideration, the receipt whereof is hereby acknowledged, the undersigned (“Grantor”) hereby grants grant UnitedHealthcare Children’s Foundation and United HealthCare Services, Inc., its parents, subsidiaries, affiliates, agents, licensees, designees, successors and assigns (collectively, “United”) permission to enter onto and film and photograph the Premises identified above on the Session Date(s) indicated and to use the resulting video, audio recordings, and photographs (the “Recordings”) in all media now known and hereafter developed, for advertising, educational, commercial and/or promotional purpose (the “Materials”) throughout the world, in perpetuity.
Grantor Intellectual Property: The above grant includes the right to film and photograph Grantor’s intellectual property, including any trademarks, service marks, trade dress, and copyrights (the “IP”) as they appear on or in the Premises in the Materials.
Grantor Acknowledgements: Grantor is the owner, the legal tenant, or otherwise controls all right, title and interest in and to the Premises. Grantor represents and warrants that it has the full right and authority to enter into and perform this Location Release and to grant the rights granted herein. Grantor acknowledges that: (a) United is not obligated to use the Materials, (b) all IP rights in the Recordings and Materials (other than the Grantor IP or third-party intellectual property rights) are owned by United, and (c) Grantor will not have the right to approve United’s use of the Recordings or Materials. Grantor further represents and warrants to United that Grantor is of legal age in the state in which Grantor resides.
Grantor Release: Grantor waives all rights and releases United from, and shall not sue United or take any other legal action against United for any claim or cause of action, whether now known or unknown, including without limitation, for defamation, invasion of right to privacy, publicity or personality or any similar claim, or based upon or relating to the use of Grantor’s Premises and/or the IP in accordance with the terms of this Location Release, and Grantor and Grantor’s heirs, representatives, executors, administrators, or any other persons acting on Grantor’s behalf or on behalf of Grantor’s estate may have now or in the future. This Location Release is a legally binding agreement and will be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
Governing Law; Entire Agreement: Grantor agrees that any disputes arising in connection with this Location Release will be governed by the laws of the state of Minnesota, without regard to its choice of law provisions. This Location Release is the complete and exclusive statement of the terms of the agreement between United and Grantor with respect to this subject matter and supersedes all prior agreements, whether written or oral.
Grantor has read this Location Release, understands it, and is signing it voluntarily:

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