PHOTO VENTURE CAMERA CLUB (“PVCC”) RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT (“AGREEMENT”)
IN CONSIDERATION of being permitted to participate in PVCC-sponsored activity/activities, I, for myself, my personal representatives, assigns, heirs and next of kin, agree as follows:

By selecting the “I agree” button, I am signing this document electronically. I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document.

By selecting “I agree” using any device, means, or action, I consent to the legally binding terms and conditions of this document.

I further agree that my signature on this document is as valid as if I signed the document in writing.

I am also confirming that I am authorized to enter into this Agreement.

If I am signing this document on behalf of a minor, I represent and warrant that I am the minor’s parent or legal guardian.
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Email *
First name of the person completing this form *
Last name of the person completing this form *
Your phone number (mobile or preferred, please include your area code) *
1. *
I acknowledge, agree and represent that I understand the nature of the activity/activities and that I am qualified, in good health, and in proper physical condition to participate in such  activity/activities. I further acknowledge that the  activity/activities may involve certain hazards. I further agree and warrant that if at any time I believe the conditions to be unsafe, I will immediately discontinue further participation in the  activity/activities.
Required
2. *
I fully understand that: (a) the activity/activities may involve risks and dangers of serious bodily injury, including permanent disability, paralysis and death, and also risk of damage or loss to equipment; (b) these risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the activity/activities, the condition in which the activity/activities takes place, or the negligence of the “Releasees” named below; and (c) there may be other risks not known to me or not readily foreseeable at this time. I fully accept and assume all such risks and responsibility for losses, costs and damages I incur as a result of my participation in the activity/activities.
Required
3. *
I hereby release, discharge and covenant not to sue the PVCC, their directors, officers, agents
and representatives (the “Releasees” herein) from all liability, claims, demands, losses or damages on
my account caused or alleged to be caused in whole or in part by the negligence of the Releasees or
otherwise, including negligent rescue operations; and I further agree that if, despite this Release and
Waiver of Liability Assumption of Risk and Indemnity Agreement, I, or anyone on my behalf, makes a
claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from
any litigation expenses, attorney fees, loss, liability damage, or cost which may be incurred as a result of
such claim.
Required
4. *
I have read this Agreement, fully understand its terms, understand that I am giving up
substantial rights by signing it and am signing 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 the Agreement is held to be invalid, the balance,
notwithstanding, shall continue in full force and effect. This Agreement shall be governed by Indiana
Law.
Required
Printed Name *
Signature *
Full legal name
Date *
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Is participant under age 18? *
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