PARENTAL CONSENT MEDIA RELEASE RELEASE FOR PARTICIPATION IN ACTIVITY
I, (Mr., Mrs., Ms.){printedName7}, the parent or legal guardian as appropriate, of {printedName} in the event titled as the "Take Down Tobacco Day Video Contest' executed by the Louisiana Campaign for Tobacco-Free Living/Next Era.
I understand that this activity may entail pre-event photo or video production meetings/activities, contest kick-off, judging day and awarding ceremony that I willingly approve his/her involvement in.
For purposes of promotion, advocacy and evaluation, I give permission to the event proponents and media entities in releasing any relevant publication (including but not limited press releases, newsletters, videotapes, reports, planning document, brochures, social media pages, websites and exhibitions) wherein my child, a minor, appears, to use and share any comments, verbal or written, made by said minor about the program, and to use said minor's name in connection with any publication and in such manner as determined by the organizers.
All videos will become property of the Louisiana Campaign for Tobacco-Free Living. We request this so we may use your video to promote safe driving to a broader audience and draw attention to this important topic. We may also share your meme and/or video on the website or other digital platform (whether you're the winner or not We are hoping to share these messages with young adults across the state and/or country.
I hereby release and discharge the Louisiana Campaign for Tobacco-Free Living, Next Era and various partner agencies, or individuals collaborating to make this contest a possibility, from any cause of action of any nature whatsoever arising from my child's participation in this contest.
In exchange for participation in Take Down Tobacco Day Video Contest (the "Activity"), organized by the Louisiana Campaign for Tobacco-Free Living/Next Era ("Releasees"), I hereby agree as follows:
1. I and anyone claiming on my behalf release and forever discharge Releasees and its affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them (collectively, the "Released Parties"), in their individual and/or corporate capacities from causes of action of any nature and kind, known or unknown, which I may have against Releasees or any Released Parties arising out of or relating to any injury, loss or damage to person and property that may be sustained as a result of participation in the Activity ("Claims" )
2. I agree to indemnify Releasees against any and all claims, actions, lawsuits, damages and judgments, including attorney's fees, arising out of or relating to my participation in the Activity.
3. This Release for Participation in Event or Activity ("Release") shall not be in any way construed as an admission by the Releasees that it has acted wrongfully with respect to me or any other person, that it admits liability or responsibility at any time for any purpose, or that I have any rights whatsoever against the Releasees.
4.This Release shall be binding upon the parties and their respective heirs, administrators, personal representatives, executors, successors and assigns. I have the authority to release the Claims and have not assigned or transferred any Claims to any other party. The provisions of this Release are severable. If any provision is held to be invalid or unenforceable, it shall not affect the validity or enforceability of any other provision. This Release constitutes the entire agreement between the parties and supersedes any prior oral or written agreements or understandings between the parties concerning the subject matter of this Release. This Release may not be altered, amended or modified, except by a written document signed by both parties.The terms of this Release shall be governed by and construed in accordance with the laws of the State/Commonwealth of Louisiana.
5.I have carefully read and fully understand all the provisions of this Release and am freely, knowingly andvoluntarily entering into this Release.
Contact Person: Kenyatta Royal
kroyal@lphi.org or 504.301.9844
Official contest rules can be located online at www.wearenextera.org/contest.