Little Sprouts Registration Form

Parent/Guardian Name:

First NameLast Name

Youth Attendee Name

First NameLast Name

Parent/Guardian Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Zip Code

Parent/Guardian Email

example@example.com

Little Sprout's Age

Have you participated in any Color The Block Activities?

Will you be seeking community service hours for this event:

Any Additional Information We Need to Know?

Hours Available for Volunteering:

How did you hear about this event?

Other

Are you interested in other upcoming internship and volunteer opportunities?

Release of Liability, Waiver of Claims, Photo Release, Assumption of Risks, and Indemnity Agreement

By agreeing to this Release of Liability, you acknowledge, appreciate, and agree as follows:

Participation and Acknowledgement of Risk:
I, the undersigned participant, wish to voluntarily participate in Color The Blocks events. I understand that the activities may involve risks of serious bodily injury, including permanent disability, illnesses, and death, which might result from my own actions, inactions, or negligence; those of others participating in the event; the condition of the premises; or the negligence of the released parties named below. I acknowledge that I am aware of the risks involved and voluntarily agree to assume these risks.

Release and Waiver:
I hereby release, discharge, and covenant not to sue Color The Block, its administrators, directors, agents, officers, volunteers, employees, and other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of the premises used to conduct the event (collectively referred to as "Releasees"), from any and all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations; and I further agree that if, despite this release and waiver of liability, I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

Photo Release Consent:
I understand that during Color The Block events, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns.

Severability:
The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

Acknowledgment of Understanding:
I have read this release of liability and assumption of risk agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

If the participant is a minor, the parent or guardian must read and acknowledge:

I, as parent/guardian with legal responsibility for this participant, acknowledge, understand, and agree to all of the above and consent to his/her release as provided above and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above.

*Submission of this form accepts and acknowledges the above Release of Liability, Waiver of Claims, Assumption of Risks, and Indemnity Agreement.

Submission Date

Date

I understand that submission of this form is an electronic acknowledgement of all the above information and constitutes equivelant as an electronic signature.

First NameLast Name