NUL x NAN Juneteenth DEI Rally Consent Form

Commemorate Juneteenth & Support DEI: Join Our Bus Trip!
Join us for a powerful bus trip to a rally hosted by the National Urban League and National Action Network. Stand in solidarity with the fight for Diversity, Equity, and Inclusion (DEI) across the nation!

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Emergency Contact Name

Emergency Contact Email

example@example.com

Emergency Contact Phone Number

Please enter a valid phone number.

Please select whether you identify as the following:

NUL STAFFNUL Young ProfessionalNUL InternOther

Media Authorization Release

I hereby grant the National Urban League permission to use my likeness in a photograph in any and all of its advertisements and other publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of the National Urban League and will not be returned.I hereby irrevocably authorize the National Urban League to edit, alter, copy, exhibit, publish or distribute these photos for purposes of publicizing the National Urban League's programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished products, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photographs.I hereby hold harmless and release and forever discharge the National Urban League from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I am 18 years of age or older and am competent to enter into a contract in my own name.

Please select "Yes" if you have read the Media Authorization Release above and fully understand the contents, meaning, and impact.*

Yes

Demonstration Protocol

This demonstration is not formally sponsored by NUL and attendance is entirely voluntary. For those who wish to participate, transportation to and from [the office] will be arranged by NUL, and optional solidarity t-shirts will be available for those who wish to wear them during the protest.

Participants are kindly reminded that they do not possess authorization to represent the League in any capacity to the press or media. Any statements made should clearly convey that they are personal opinions and not reflective of organizational positions.

Even though your participation is in your individual capacity, we ask that all attendees adhere strictly to the values upheld by the National Urban League and the objectives of the protest. This includes refraining from engaging in any unlawful activities or behaviors contrary to public policy. Such actions encompass but are not limited to obstructing traffic, blocking entrances, impeding pedestrian movement, or causing damage to property.

Individuals who wish to attend the protest will be excused from attending work during that time. You will not need to use accrued PTO to cover this absence should you decide to attend the protest. The travel to and from the protest will not count towards overtime.

Please contact Miguel Clarke (mclarke@nul.org) with any questions.

Please select "Yes" if you have read the Demonstration Protocol above and fully understand the contents, meaning, and impact.*

Yes