Waiver and Release: In consideration for permitting me and/or my child to participate in the activities described herein, and intending to be legally bound, I agree, certify and represent on behalf of myself, my spouse, my child, and our respective heirs, executors, administrators, representatives, and/or assigns (if any), that I, my child, and been advised by a health care professional against participation in the activities described herein or any activities sponsored by the Native Americans for Community Action (NACA) Health Promotion Program (collectively "Activities"); (2) agrees to abide by all NACA Health Promotion Program rules; (3) is aware of the risks inherent in the Activities; that the Activities may be physical, require considerable running, starting, stopping, and physical exertion in heat and humidity, and involve other individuals and man-made and natural obstacles; and that the Activities could potentially lead to injuries including, but not limited to, overheating, dehydration, injuries, disability, death, and property damage; (4) will conduct him/herself at a level consistent with his/her skill while participating in the Activities; (5) maintains adequate health insurance to cover any injuries while participating in the Activities; (7) gives permission to the NACA Health Promotion Program to photograph the Participant (including children) and use the Participant's name (collectively "Image") for purposes including publicity and publication of the Image in any medium and will not seek compensation for such; (8) gives permission to be included in surveys that will be anonymous and will be shared with grant funder such as CDC, Good Health and Wellness In Country (GHWIC) and Tribal Practices and Wellness in Indian Country (TPWIC) (9) has fully read and understands this Waiver and Release and acknowledges that this is a release of liability, a waiver of claims, and an assumption of risks; (10) assumes all risks and accepts full responsibility for any injuries, death, and/or property damage which may result from participation in the Activities; and (11) forever releases, fully discharges, and agrees to indemnify, defend, and hold harmless the NACA GHWIC Program, other Community (Native Americans for Community Action) to herein as “Releases”) from and against all claims, causes of action, responsibility, liability, damages, losses, costs and expenses (including attorneys’ fees and court costs) attributable directly or indirectly to or arising out of the Participant's and/or Releases’ acts or omissions related to or connected with the Activity, the Image, and/or the Participant’s participation in the Activity.
