Liability Waiver and Publicity Consent
Welcome to Power of We (“POW”)! We are excited to have fun and work with you and your family. The safety of all POW participants is very important to us. Please read this form carefully, fill out the relevant information, and sign at the bottom of this form or submit a digital signature.
I, ________________________, the parent or guardian of ______________("Youth") give permission for Youth to participate in the “Program” with POW. By signing this Liability Waiver and Publicity Consent, I consent to the following terms:
Liability Waiver
Safety. I understand that Youth must follow instructions, uphold all safety rules and directions implemented by POW, use any equipment properly and behave responsibly so as to avoid any injuries to Youth or any other person at the site. I confirm that Youth is in adequate physical condition to participate.
Awareness and Assumption of Risk. I understand that participation in the Program has risks that may arise from Youth's actions, inactions or negligence, or the actions, inaction or negligence of POW, its directors, officers, employees, members, agents, affiliates, volunteers, and any sponsor of the Program (collectively, the "Released Parties"), other participants, or others present at the site. These risks may include but are not limited to: exposure to COVID-19, illness, personal injury, property damage and/or death. I assume full responsibility for any and all risks of bodily injury, death or property damage caused by or arising directly or indirectly from Youth's presence at site or participation in the Program, regardless of the cause.
Waiver and Release of Claims. In consideration for Youth’s participation in the Program, I waive and release the Released Parties from any and all liability, loss, damages, claims, expenses and attorney’s fees of any kind which I or Youth may have or which may later accrue, resulting or arising directly or indirectly from Youth's participation in the Program or presence at the site. This release and waiver includes, in each such case, all claims in respect of the risks noted above, known and unknown, whether caused by the negligence of the Released Parties, or otherwise. I agree not to sue any of the Released Parties on the basis of these waived and released claims. I further agree to indemnify, hold harmless, and defend POW and the Released Parties from any and all claims resulting from injuries, damages and losses sustained by me or by the Youth arising out of, in connection with, or in any way connected with or in any way associated with the activities of the Program.
Medical Treatment Consent and Waiver. If Youth is injured and requires medical attention while participating in the Program, I give consent and authorize POW to provide Youth first aid and, through medical personnel of its choice, medical assistance, transportation, and emergency medical services. This consent does not impose a duty upon POW to provide such first aid, medical assistance, transportation or services. In addition, I waive and release any claims against the Released Parties arising out of any first aid, medical assistance, treatment or services, including the lack or timing of such, rendered in connection with Youth's participation in the Program. I understand that POW does not provide health, medical, disability, or other insurance coverage for Youth.
Publicity Consent
Consent. In consideration for the opportunity for Youth to participate in Program, I authorize POW, including its employees, volunteers, officers, directors, independent contractors, and agents of each and all of them (collectively, “Representatives”), to photograph, video, film, and/or interview Youth and to display, publicly perform, exhibit, transmit, broadcast, reproduce, record, photograph, create derivative works, license, otherwise use, and permit others to use Youth’s statements, image, voice, likeness, appearance and/or story, in any format, including photos, film, video, audio, print or electronic (together, the “Materials”), and grant to POW and its Representatives the unrestricted, perpetual, and worldwide right and license to use the Materials in any medium or format whatsoever now existing or hereafter created, as they determine in their sole discretion without further consent from or royalty, payment, or other compensation to me, except as otherwise expressly provided in this agreement. I agree that POW and its Representatives may make the Materials available in any of its internal or promotional materials, including in or on brochures, advertisements, newspapers, websites, social media, videos, publications or any other media. I understand that I am not entitled to inspect or approve the use of the Materials or receive notice of their use or publication.
POW's Rights in the Materials. POW and its Representatives shall be the exclusive owner of all rights, including copyright, Youth may have in the Materials. I hereby irrevocably transfer, assign, and otherwise convey to Company Youth’s entire right, title, and interest, if any, in and to the Materials and all copyrights and other intellectual property rights in the Materials arising in any jurisdiction throughout the universe in perpetuity. I acknowledge and agree that POW and its Representatives own the physical Materials.
Waiver of Legal Claims. In addition, to the fullest extent permitted by law, I hereby irrevocably waive and release POW and its Representatives from any and all liabilities, claims, demands, actions, suits, damages, and expenses, including but not limited to claims for copyright or trademark infringement, invasion of any rights of privacy, violation of rights of publicity, or any similar claim or cause of action in tort, contract, or any other legal theory, now known or hereafter known in any jurisdiction throughout the world (collectively, “Claims”) arising or resulting directly or indirectly from POW or its Representatives’ exercise of their rights under this Agreement or the production, exhibition, exploitation, advertising, promotion, or other use of the Materials.
No Compensation. I also understand that neither I nor Youth will receive any compensation for the use of the Materials by POW or its Representatives.
If you do not wish to agree to this Clause II (Publicity Consent), please check this box: □
I have been given a full opportunity to review and ask questions about this document. I fully understand all of the terms of this document and understand that I am giving up certain legal rights by signing it. I sign it voluntarily and knowingly. I am the parent or legal guardian of the Youth named below. I have the legal right, power, and authority to consent to this Liability Waiver and Publicity Consent on behalf of the Youth listed below and myself. I am of lawful age and legally competent to sign this waiver and consent. By signing below, I hereby consent to and approve in all respects of the terms and conditions of this Liability Waiver and Publicity Consent and agree that both the Youth and I shall be bound by all of its terms and conditions.
Youth’s Name:
Parent’s/Legal Guardian’s Name:
Parent’s/Legal Guardian’s Signature:
Date: