PHOTO RELEASE/WAIVER OF LIABILITY
I hereby grant the Fielkow-Chase Youth Education Initiative permission to use my likeness in a photograph, video, or other digital media ("photo") in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of the Fielkow-Chase Youth Education Initiative and will not be returned. I hereby irrevocably authorize the Fielkow-Chase Youth Education Initiative to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. I hereby hold harmless, release, and forever discharge the Fielkow-Chase Youth Education Initiative 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 HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR WAIVER AND RELEASE OF LIABILITY.
I affirm that the student named below will be voluntarily participating in the eighteen month Fielkow-Chase Youth Education Initiative. I understand that participation in Fielkow-Chase Youth Education Initiative activities could involve the risk of personal injury, illness, death, or property damage or loss and that the Fielkow-Chase Youth Education Initiative cannot and does not guarantee safety therefrom. The Fielkow-Chase Youth Education Initiative does not provide health and accident insurance for cohort participants, and understand that any medical expenses, property loss, or other personal expenditures that result during or from this program are to be borne by the student or by their parent/guardian. I also hereby consent and give authorization to Fielkow-Chase Youth Education Initiative ("program") leaders to secure any emergency medical treatment for the student as necessary, and agree to be responsible for the costs thereof.
IN CONSIDERATION OF THE OPPORTUNITY AFFORDED FOR THE STUDENT TO PARTICIPATE IN THIS PROGRAM, I, ON BEHALF OF MYSELF AND THE STUDENT, AGREED TO RELEASE AND ACKNOWLEDGE THAT THE STUDENT is PARTICIPATING IN THE PROGRAM VOLUNTARILY AND AT HIS/HER OWN RISK; ASSUME ALL RISKS ASSOCIATED WITH THE PROGRAM; AND AGREE TO RELEASE, DISCHARGE, DEFEND, INDEMNIFY, AND HOLD HARMLESS THE FIELKOW-CHASE YOUTH EDUCATION INITIATIVE AND ITS OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, AND REPRESENTATIVES FROM AND AGAINST ALL RIGHTS AND CLAIMS ARISING FROM ANY PERSONAL INJURY, DEATH, OR PROPERTY LOSS OR DAMAGE THAT THE STUDENT MAY SUFFER DURING, OR. AS A RESULT OF, HIS/HER PARTICIPATION IN THE PROGRAM.
This release is intended to discharge the Fielkow-Chase Youth Education Initiative and its officers, directors, employees, and representatives from any and all liability arising from, or connected in any way with, the student's participation in the program, even though that liability may arise from negligence or carelessness on the part of the persons or entities mentioned above, to the fullest extent permitted by law. The provisions of this Waiver and Release are severable. Should any part, term, or provision of this Waiver and Release be declared to be illegal or invalid, the validity of the remaining parts, terms, and provisions shall not be affected thereby, and said illegal or invalid part, term, or provision shall be deemed severable and not a part of this Waiver and Release. Selection to the Fielkow-Chase Youth Education Initiative cohort is strictly at the discretion of the Board of Directors. I, on behalf of myself and the student, agree to release, discharge, defend, indemnify, and hold harmless the Fielkow-Chase Youth Education Initiative and its officers, directors, employees, agents, and representatives from and against all rights and claims arising from the selection of the cohort.