To the best of my knowledge, all information given is correct. I hereby give permission for the person listed above to attend the Gravity Racing Challenge STEM Summer Program. I hereby authorize the leaders or designated medical professionals to administer emergency medical assistance if I cannot be reached. I accept responsibility of payment of expenses incurred as a result of medical treatment. I, the legal parent/guardian, hereby certify and grant permission for my son/daughter/wardto participate in the Gravity Racing Challenge STEM Summer Program in Akron, OH. Finally, I, as such parent or guardian, in consideration of the benefits received by myself and child and the other participants herein, hereby waive and release all claims, rights, causes of action, demands or otherwise, whether for personal injuries, property damage, or any other loss, damages or expenses which I, as a parent/guardian, and/or my son/daughter/ward may have against the Local Soap Box, its sponsors, the International Soap Box Derby Inc., and/or its sponsors, agents, employees, full or part-time, or associates of any status whatsoever, arising from or in any manner related to my son's daughter's or ward's participation in the Gravity Racing Challenge STEM Summer Program, the International Soap Box Derby, Inc., and/or any activities incidental or related thereto.
I also give permission and consent for myself/son/daughter/ward in all photographs, videotapes, likeness of image or interviews to be published and used to illustrate, promote , and advertise the Gravity Racing Racing STEM School Challenge Program, Soap Box Derby STEM Summer Program, and International Soap Box Derby, Inc., use of any such photographs, videotapes or interviews may include, but is not limited to, use on the internet websites promoting the Gravity Racing Challenge STEM School Program, I further waive any claim for compensation of any kind, for the International Soap Box Derby’s use or publication of photographs of me and/ or those of my minor children (if applicable). I hereby fully and forever discharge and release the International Soap Box Derby Inc. from any claim for damages of any kind (including, but not limited to, invasion of privacy; defamation; false light or misappropriation of name or image.) arising out of the use or publication of photographs or me and/or those of my minor children (if applicable) by the International Soap Box Derby Inc. and covenant and agree not to sue or otherwise initiate legal proceedings against the International Soap Box Derby Inc., for such use or publication on my own behalf or on behalf of my minor children. All grants or permission and consent, and all convents, agreements and understandings contained herein are irrevocable.