Release and Indemnification (BLANKET PERMISSION STATEMENT)Activities at the COHORT may include off site excursions that will be conducted outside andm ay involve vehicular transportation or walking which include the risk of being exposed to potential hazards and risks inherent in such activities including but not limited to vehicle accidents, physical exertion, falls, burns, cuts and contact with other participants. I hereby acknowledge these risks and expressly assume all risks, including personal injury and fatality, arising out of my child‛s participation in the cohort. I acknowledge and agree that it is my responsibility to ensure that my child‛s clothing and equipment are appropriate and properly fitted for use in included activities. I represent and warrant that my child is physically fit and able to participate in cohort activities. My child has been instructed to stop and request assistance if he/she experiences any symptoms such as, but not limited to, dizziness, excessive fatigue, shortness of breath, pain or any other conditions that would make participation in activities difficult or unsafe to continue. I agree, for myself, my heirs, executors and administrators, not to sue and to release, indemnify, defend and hold harm less the WHERE I STAND or any of it's collaborative partners and/or their affiliates, officers, directors, volunteers, employees and agents, and all sponsoring businesses and organizations and their agents and em ployees, from and against any and all liability, claims, demands, and causes of action whatsoever, arising out of or brought in connection with my child‛s participation in this event and related activities – whether resulting from the negligence of any of the above or from any other cause. Furthermore, I authorize the use or publication of my child‛s name, image or voice as may be captured by photograph or recording while participating in this program in any medium for any purpose, including illustration, promotion or advertisement. The copyright(s) in such photograph, recording, illustration, promotion or advertisement or other material shall be owned by the COHORT. The foregoing release and indemnification agreement shall be as broad and inclusive as is permitted by the State or Province in which the activity is conducted. If any portion of it is held invalid, the balance shall continue in full force and effect. I have read, understand and agree to the term s of this Agreement. I am the legal guardian of the participant, and I hereby consent to his/her participation. I have read and explained the foregoing release and indemnification agreement I hereby agree to its terms on behalf of myself and the cohort. *
