Permission and Consent Form
Important:
This is a legal document pertaining to your rights. Please read in entirety
before signing. If you have questions, consult an attorney. Everyone under the
age of 18 must have the following completed by a parent or legal guardian,
prior to participating.
In this
Agreement:
A. “Event
Organizer” means Gulf Coast Regional Blood Center, Gulf Coast Marrow Donor
Program and their owners, vendors, subsidiaries, affiliates, predecessors, successors,
officers, directors, employees, agents, assigns, and insurers;
B. "Sponsors"
means Gulf Coast Regional Blood Center and sponsors or promoters of Lace Up 4
Life, and all such parties' respective owners, vendors, subsidiaries,
affiliates, predecessors, successors, officers, directors, employees, agents,
assigns, and insurers;
C. "Event"
means Lace Up 4 Life, including but not limited to, the 5K, 1K, and Tot Trot, ;
and
D. "My
Claims" means any and all rights and claims that the signatory or has, may
have, or that hereafter may accrue, arising from participation or volunteering
in the Event, on whatever basis and from whatever source, even if the claims
arise out of the Sponsors' negligence. Without limitation, My Claims includes
rights and claims for personal injury, bodily injury, death, property damage,
property interests, pain and suffering, medical expenses, income loss and loss
of earning capacity, punitive damages, loss of consortium, attorney fees,
costs, and any other right or claim of any sort.
AGREEMENT
AND REPRESENTATIONS
1. In consideration for the opportunity to
participate in the Event, and for other good and valuable consideration, the
receipt and sufficiency of which I acknowledge, I hereby waive, release, and
discharge, for myself, heirs, executors, administrators, and legal representatives
(including their successors), My Claims against the Sponsors.
2. I recognize and freely acknowledge the risks
and dangers of participating in the Event and fully assume all such risks and
dangers arising from that participation, without limitation including
accidents, physical injuries or death, property damage, any results of my
negligence or the negligence of other participants or the Sponsors, any results
of failures in my or others' equipment, possible physical and/or mental
exhaustion, and all the costs and expenses I incur with respect to these risks
and dangers. Neither I nor my beneficiaries, heirs, next of kin, spouses, or
assigns will sue or make any claims against the Sponsors in connection with My
Claims or the risks and dangers I have assumed. I recognize and freely
acknowledge that the Event requires adequate physical and mental conditioning,
and I represent that I am in sound physical and mental condition, sufficient to
participate in the Event. I have no physical or mental impairment that would
endanger others or me.
3. I agree that I will bear all liability and
other costs and expenses that I incur from my participation in the Event,
without limitation including all costs and expenses I incur for personal or
property injury caused by my negligence or the negligence of others.
4. I agree to indemnify and hold the Sponsors
harmless from claims by any person or entity who sues or makes a claim as a
result of my participation in the Event, without limitation including all
medical providers and insurers suing or making such claims.
5. I recognize and freely acknowledge that the
Sponsors make no express or implied warranties with respect to the Event,
without limitation including any warranties with respect to the conditions of
the location, the equipment used by me and/or others, and the conduct of any
and all persons involved in the Event. I further recognize and freely
acknowledge that the Sponsors expressly disclaim all legal liability and
responsibility with respect to such matters.
6. If I am injured while participating in the
Event, I consent to emergency medical care being obtained for and/or provided
to me.
7. I understand and agree that situations may
arise during the Event that may be beyond the control of the participants or Sponsors.
I accept responsibility for my own conduct and actions, and I recognize and
expressly acknowledge that the Sponsors have discretion over and the right to
final determination regarding the propriety and/or acceptability of my conduct
and actions in participating in the Event; I further acknowledge that I may be
asked to leave or may be removed from the Event if my conduct and actions are
determined to be improper or unacceptable.
8. I understand and agree that my photograph or
video images and recordings of my voice may be made and/or used, in any form,
in memorializing, promoting, or advertising this or other Gulf Coast Regional
Blood Center and Gulf Coast Marrow Donor Program events, and that no
compensation will be due to me in that regard. I irrevocably grant Gulf Coast
Regional Blood Center and Gulf Coast Marrow Donor Program, or persons acting
for or on behalf of Gulf Coast Regional Blood Center or Gulf Coast Marrow Donor
Program, the right and authority to copyright, use, and publish, for these
purposes, images and recordings that it or they create. This right and
authority shall belong to such party or parties at all times and survive the
termination of this Agreement.
9. I agree that I am of the age of majority or
that, if I am a minor, I have obtained the permission(s) of at least one parent
or legal guardian, for my participation in the Event, as more fully established
below. I represent that if I have presented identification to establish my age,
the identification is state-issued, was validly sought by and issued to me, and
is a true and accurate statement of my age.
10. I understand and agree that this Agreement
contains all of the agreements between and among the Sponsors and me, and that
we have no other written or oral agreements.
11. I have read this Agreement carefully and I
understand all of it. I understand that I am free to consult with an attorney
of my own choosing if I wish. In signing this Agreement, I have not relied on
any statements or explanations by the Sponsors or any of their representatives.
PARTICIPANT PERMISSION AND CONSENT
By signing this document, I pledge that I have
read this document and understand it includes a release of all claims. I
acknowledge, appreciate, and assume all risks and dangers, voluntarily and freely,
without coercion or duress, as provided herein. This agreement may not be
modified orally and may not be waived in any respect.
PARENT/GUARDIAN PERMISSION AND CONSENT
I, as a parent or legal guardian of the above
named minor, hereby give my permission and consent, voluntarily and freely, for
my child to participate in the Event. I further agree to the above provisions,
both individually and on behalf of the minor identified above, after having
read this Agreement fully.
