Participant's Information * Gender * Age * If "Yes" to allergies, please list the allergies below: Other Dietary Need If participant lives in a group home, please list the name of the group home. Parent/Guardian Information Phone Number * Secondary Phone Number * Email * Night to Shine Media (Photo) Rights & Liability Release
Night to Shine Participant Liability & Rights Release for Photos and/or other Media By signing below, and for the proof and valuable consideration of participating in an event hosted by Trinity United Methodist Church and Sacred Heart Catholic Church, and sponsored in part by or associated with the Tim Tebow Foundation, I hereby give my full consent to Tim Tebow Foundation, Inc., ("TTF") a Georgia nonprofit corporation headquartered in Florida and Trinity United Methodist Church and Sacred Heart Catholic Church ("CHURCH"), North Carolina nonprofit corporations, to record, by writing, by video, photographic, or audio recording device, or by any other analog or digital means, the actions, physical likeness, biographical information, and/or voice of me and/or any person of whom I am the parent or legal guardian, including minor children (collectively compensation now or in the future, all rights of every kind and character whatsoever, in perpetuity, in and to any and all such recordings, along with any additional recordings I might provide to TTF and CHURCH as a result of its use of any of the foregoing recordings. Among other things, TTF and CHURCH may, but are not required to, copy or reproduce the recording, edit or modify it, incorporate it into another work, display or broadcast it or any of the foregoing privately or publicly, and use or license it or any of the foregoing for use by others, all for the sole benefit and at the sole discretion of TTF and CHURCH, for the advancement of TTF and CHURCH's exempt charitable purposes. All permissions granted herein extend to any successor or assign of TTF and CHURCH and bind the Participants and their heirs, successors, and assigns. I, on behalf of all Participants, hereby release and discharge and agree to hold harmless TTF and CHURCH, its directors, officers, employees, volunteers, and independent contractors, from any and all claims or damages, including but not limited to defamation or violation or rights of privacy or publicity arising from or associated with the recording or the use of the recordings. This release shall be construed, interpreted and governed in accordance with the laws of the State of Florida, and should any provision of this release be determined invalid, such invalidity does not affect any of the remaining provisions. I am of full age and have the right to contract in my own name and for each Participant.
I have read the above Media/Photo/Liability Rights Release * BRUNSWICK COUNTY NIGHT TO SHINE RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AND PARENTAL CONSENT AGREEMENT (“AGREEMENT”)
Event – Night to Shine and Shine-Thru
In consideration for permitting Participant to participate as an Attendee at the Event as directed by the relevant staff, the undersigned, for themselves, and for their respective heirs, personal representatives and assigns, agree as follows:
Assumption of Risk: The undersigned hereby acknowledge and agree that they understand the nature of the Event and that Participant is qualified, in good health, and in proper physical condition to participate therein; that there are could be risks and dangers associated with the Event; and that, except as expressly set forth therein, they knowingly and voluntarily, accept and assume responsibility for such risks and dangers, and all other risks and dangers that could arise out of, or occur during Participant’s participation in the Event.
Release and Waiver: The undersigned hereby release, waive, discharge and covenant not to sue Trinity United Methodist Church of Southport NC, Sacred Heart Catholic Church of Southport NC and Tim Tebow Foundation or any subdivision thereof, and each of them, their officers and employees,(collectively the “Releasees”), from and for any liability resulting from any personal injury, accident or illness (including death) and/or property loss, however caused, arising from, or in any way related to, Participant’s participation in the Event, except for those caused by the willful misconduct, gross negligence or intentional torts of the above parties, as applicable.
Indemnification and Hold Harmless: The undersigned also hereby agree to indemnify, defend and hold the Releasees harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities including but not limited to, attorney’s fees, arising from, or in any way related to, Participants participation in the Event, except for those arising out of the willful misconduct, gross negligence or intentional torts of the above parties, as applicable.
Severability: The undersigned expressly agree that the foregoing assumption of risk, release and waiver of liability and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of North Carolina and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
Acknowledgment of Understanding: The undersigned have read this assumption of risk, release and waiver of liability and indemnity agreement and have had the opportunity to ask questions about the same. The undersigned fully understand this assumption of risk, release and waiver of liability and indemnity agreement, that the undersigned are giving up substantial rights in connection therewith, and that its terms are contractual, and not a mere recital. The undersigned acknowledge that they are signing the agreement freely and voluntarily.
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
I have read the above Liability Release * Minor Release
AND I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF NIGHT TO SHINE ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE’S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS, WILLFUL MISCONDUCT, GROSS NEGLIGENCE OR INTENTIONAL TORTS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR’S BEHALF MAKES A CLAIMS AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, REIMBURSE, DEFEND, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR ANY COSTS THAT MAY OCCUR AS A RESULT OF ANY SUCH CLAIM