Parent/Guardian, under penalty of perjury, do hereby affirm to the Joliet Area/South Suburban Alumnae Chapter (JASSAC) Chapter of Delta Sigma Theta Sorority, Incorporated that I authorize the participation of Participant Minor Child, in the JASSAC Youth Empowerment Event, and that I have the legal authority to provide my consent and authorization for such participation.
WAIVER AND RELEASE
Parent/Guardian, on behalf of (“Participant Minor Child”) do hereby release, waive, discharge, covenant not to sue and agree to hold harmless Delta Sigma Theta Sorority, Incorporated (“Delta”), its officers, National Executive Board, employees, members, local chapters, representatives, agents, affiliates, and assigns (collectively “Releasees”), from any and all claims, demands, and actions of any and every kind directly or indirectly arising out of, or relating in any respect to Participant Minor Child’s participation in the JASSAC Youth Empowerment Event.
My waiver and release of all claims, demands, actions, and liability shall include without limitation, any injury, illness, death, property damage or loss to the Participant Minor Child which may be caused by any act, or failure to act, by the Releasees, unless such injury, illness, death, property damage or loss is a direct result of the willful misconduct of any Releasee.
I understand that, without limitation of the foregoing, neither Delta, nor the Program, shall be liable and each is hereby released from all claims that may arise from loss or damage to the Participant Minor Child’s personal property.
PHOTO RELEASE FORM
I grant permission to Delta Sigma Theta Sorority, Inc. Joliet Area/South Suburban Alumnae Chapter (JASSAC) to use photographs taken of me on the date and at the location listed below for use in brochures, newsletters, and magazines, and to use the photographs on display boards, and to use such photographs in electronic versions of the same publications or on JASSAC web sites or other electronic forms or media, and to offer them for use or distribution in other publications, electronic or otherwise, without
I hereby agree to release, defend, and hold harmless JASSAC or any firm publishing and/or distributing the finished product in whole or in part, whether on paper, via electronic media, or on web sites, from and against any claims, damages or liability arising from or related to the use of the photographs, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.
I am 18 years of age or older and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release.
Location of Photo and Date:
Unleashing the Power in You- Youth Empowerment Event
Hillcrest High School
17401 Pulaski Road
Country Club Hills, IL
Date: February 24, 2018
By submitting the registration, you are agreeing to these terms.