Neon Haunted Hayride

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.We use this to send you information about our Neon Night Out.

Please provide your university email.

3

Phone* This field is required.We use this to carpool or contact you during our Neon Night Out.

Please enter a valid phone number.

4

Carpool Role* This field is required.We are meeting in front of the cafeteria at Coffman. Let us know if you can drive! Drivers get $10 for gas.

I can ride in the carpool.

I can drive and bring my car.

5

WaiverI understand that participation in the Neon Night Out activity organized by Neon Students (Wesley Foundation at the University of Minnesota), hereafter “Neon Students," is voluntary. I acknowledge that such participation involves inherent risks, including but not limited to slips, falls, collisions, loud noises, flashing lights, sudden scares, weather conditions, possible contact with props or other participants, and other unforeseen hazards. In consideration of being permitted to participate, I, on behalf of myself and my heirs, parents, guardians, and legal representatives, hereby: Release of Liability – Release and hold harmless Neon Students, its trustees, officers, employees, volunteers, faculty, agents, partners, co-sponsoring institutions, and their representatives from any and all liability for injury, death, or loss to person or property arising out of or in connection with my participation in this activity. Assumption of Risk – Acknowledge and voluntarily assume full responsibility for all risks associated with participation in this activity. Conduct – Agree to conduct myself in a safe, respectful, and prudent manner while participating in this activity, and to follow all instructions from event organizers. Medical Authorization – Authorize Neon Students staff or volunteers to seek emergency medical care on my behalf if necessary. I accept responsibility for any medical expenses incurred. Indemnification – Agree to indemnify and hold harmless Neon Students and its representatives from any claims, damages, or expenses (including legal fees) resulting from my actions during participation. Media Release – Grant Neon Students permission to use my likeness in photographs, video, or other media in any and all publications, including web-based publications, without payment or other consideration. Severability – Agree that if any portion of this waiver is found invalid, the remaining provisions shall remain in effect.

Powered by Jotform SignClear