1. Waiver and Release. I, the Participant, release and forever discharge and hold harmless Simply Smiles, its directors, officers, employees, agents, volunteers, advisors, successors and assigns (hereinafter “Released Parties”) from any and all liability, claims, and demands, either in law or in equity, that I, my spouse, children, heirs and personal representatives, may have against the Released Parties with respect to any bodily injury, personal injury, illness, death or property damage that may result from my participation, whether such liability, claims or demands result from negligence or from some other cause. I also understand that the Released Parties do not assume any responsibility or obligation to provide financial or other assistance, including but not limited to medical, health or disability insurance, in the event of injury, illness, death or property damage.
2. Insurance. I, the Participant, understand that the Released Parties do not carry or maintain, and expressly disclaim responsibility for providing, any health, medical, or disability insurance coverage for the Participant. I expressly waive any such claim for compensation or liability on the part of the Released Parties in the event of such injury or medical expense.
Each Participant is expected and encouraged to obtain his or her own medical or health insurance coverage.
3. Medical Treatment. I, the Participant, hereby release and forever discharge the Released Parties from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with my activities with Simply Smiles.
4. Assumption of Risk. I, the Participant, acknowledge that time spent traveling and volunteering with Simply Smiles, and my participation in this Simply Smiles volunteer experience, involves risk and may include activities that may be hazardous to me. I, the Participant, also recognize and understand that my time with Simply Smiles may, in some situations, involve inherently dangerous activities. As a volunteer, I hereby expressly assume the risk of injury or harm in these activities and release the Released Parties from all liability for injury, illness, death, or property damage resulting from the activities during my time working/volunteering with Simply Smiles, including, but not limited to unfamiliar or difficult terrain, exposure to insects, including but not limited to ticks and mosquitos (which can result in insect-borne diseases), extreme climate (which can result in sunburn, heatstroke, altitude sickness, or dehydration), acts of God, unfamiliar and/or poorly processed food and drink, substandard or remote and not immediately available medical care, uncommon disease, infection, virus and illnesses, poor safety and sanitary practices, lack of adequate public infrastructure, political unrest, terrorism, and unconventional customs and practices.
5. Model Release. During your week with us, you and the Simply Smiles staff will document the experience through photos and videos. With your consent, we may use some of these photos and videos on our social media pages and website, as well as in presentations and our own promotional mailings to garner more support for our work. I, the Participant, in consideration of myself, (or my child or ward), as a model, upon the terms herewith stated, hereby grant to Simply Smiles Inc. and its staff, legal representatives, and associates:
The irrevocable and unrestricted right and permission to copyright in its name and distribute, use, re-use, publish, and republish photographs and audio and video recordings of myself, (my child or my ward), now or hereafter known for illustration, art, promotion, advertising, trade, or any other purpose whatsoever.
I hereby relinquish any right that I may have to examine or approve complete product or products or the advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied.
I hereby release, discharge, and agree to save harmless Simply Smiles Inc. and its staff, legal representatives, and affiliates from any claims for libel or invasion of privacy.
I understand that no compensation will be forthcoming.
I understand that Simply Smiles Inc. has the right to use my (my child or my ward's) name in conjunction with any photograph or recording of me (my child or my ward).
I understand that this is a blanket model release that is binding for any and all photographs and recordings taken by or submitted to Simply Smiles Inc., now and hereafter known.
I hereby affirm that I am over the age of majority and have the right to contract in my own name (the name of my child or ward). I affirm that I am the parent or legal guardian of my child or ward. I have read the above authorization, release and agreement, prior to its execution; I fully understand the contents thereof. This agreement shall be legally binding upon me (my child or my ward) and my legal representatives.
6. Other. I, the Participant, expressly agree that this Release is intended to be as broad and inclusive as permitted by applicable law and that this Release shall be governed and interpreted in accordance with the laws of the State of Connecticut. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release, which shall continue to be enforceable.