Liability Waiver

Name of event*

TRIUMPH FOUNDATION INSURANCE WAIVER/RELEASE OF LIABILITY/MEDIA RELEASE FORM

Name*

DOB*

Email*

Phone*

Address*

Veteran?*

Gender*

Are you a person with a disability?*

Disability Type*

Injury Description*

Date of injury/diagnosis*

Cause of injury*

Does your family member (or loved one) have a disability?*

Tell us more

Is this your first Triumph Event?*

Date

Emergency contact name*

Emergency contact phone*

Are you under the age of 18?

Parent/Guardian Name*

Relationship*

Parent/Guardian Phone*

If APPLICANT IS UNDER THE AGE OF 18, A PARENT OR GUARDIAN SIGNATURE IS REQUIRED.

PARENT OR GUARDIAN PLEASE SIGN THIS FORM WHEN PROMPTED (AFTER CLICKING THE REGISTER BUTTON BELOW).

I agree to be on-site and provide supervision during the volunteer service*

Yes

TRIUMPH FOUNDATION WAIVER & RELEASE OF LIABILITY FORM

In consideration of being allowed to participate in any way in and/or observe TRIUMPH FOUNDATION’s programs, related events, and activities, I and/or the minor participant, for myself, and on behalf of my heirs, assigns, personal representatives and next of kin, the undersigned:

1. Agree that prior to participating, I will inspect the facilities and equipment to be used, and if I believe, to the best of my ability, that anything is unsafe, I will immediately advise TRIUMPH FOUNDATION of such condition(s) and refuse to participate.

2. Acknowledge and fully understand that I and/or the minor participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result from my own actions, inactions or negligence of others, the rules of play, or the condition of the premises or any equipment used. Further, that there may be other risks not known to me or not reasonably foreseeable at this time.

3. Assume all the foregoing risks and accept responsibility for the damages following such injury, permanent disability or death.

4. To the fullest extent permitted by law release, waive, discharge and covenant not to sue TRIUMPH FOUNDATION, or its affiliates, their representative administrators, directors, agents, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, their heirs, and if applicable, owners, lessees and/or lessors of premises used to conduct the event, all of which are hereinafter referred to as "releasees", from demands, losses or damages on account of any injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of TRIUMPH FOUNDATION and/or any of the releasees or otherwise.

MEDIA/PHOTO WAIVER

I hereby authorize and give my full consent to TRIUMPH FOUNDATION to copyright and/or publish any and all photographs, videotapes and/or film in which I appear while attending a TRIUMPH FOUNDATION event. I further agree that TRIUMPH FOUNDATION may transfer, use or cause to be used, these photographs, videotapes, or films for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations.

WAIVER OF LIABILITY RELATING TO CORONAVIRUS/COVID-19

TRIUMPH FOUNDATION The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread the disease. The exact methods of spread and contraction are unknown. Evidence has shown that COVID-19 can cause serious and potentially life-threatening illness and even death.

Participant understands that, pursuant to the CDC, state and local health agencies’ guidelines, it is prudent that he/she takes precautionary and preventative steps while attending or participating in Triumph Foundation (“Triumph”) events, to protect himself/herself, other participants and staff, and otherwise mitigate the spread of the novel coronavirus (COVID-19).

Accordingly, participant, for himself/herself, heirs and next of kin, hereby certifies that he/she has reviewed this Waiver, and signs/agrees with it voluntarily and on his/her own free will:

• Participant should be free from any known physical or health problems involving COVID-19, or any other communicable disease, when attending or participating in a Triumph event.

• Participant understands and agrees that if he/she has received a lab-confirmed diagnosis or is experiencing symptoms of MRSA, influenza, and COVID-19, or any other communicable disease, or if he/she has come into contact with a person known to have contracted COVID-19, or any other communicable disease, for the sake of the common good and health of others attending or participating in a Triumph event, he/she will refrain from attending or participating in a Triumph event for at least fourteen (14) days since such diagnosis or contact, or as otherwise recommended by a health professional.

• Participant understands and agrees that, at all times while attending or participating in a Triumph event, he/she will adhere to all Triumph rules, regulations and restrictions, and the social distancing and other Covid-19 guidelines set forth by federal, state and local health officials, which include, but may not be limited to, Governor Newsom’s Executive Orders N-33-20 and N-60-20 and The Los Angeles Department of Public Health’s Order of the Health Officer, “Reopening Safer at Work and in the Community for Control of COVID-19,” Issued June 11, 2020.

Triumph cannot prevent you or your child(ren) from becoming exposed to, contracting, or spreading COVID-19 while attending or participating in Triumph’s events. It is not possible to prevent against the presence of the disease. Therefore, if you choose to attend or participate in a Triumph event you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19. ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children in order to attend or participate in a Triumph event. These services are of such value to me and/or to my children, that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to attend or participate in a Triumph event.

WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Triumph and its owners, officers, directors, managers, officials, volunteers, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to attending or participating in a Triumph event. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I/WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, HAVE NOT CHANGED IT ORALLY, AND SIGN IT VOLUNTARILY.*

Yes

FOR MINOR AGE PARTICIPANTS - This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of TRIUMPH FOUNDATION and/or any of the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.*

Yes

Please Note: After clicking the Submit button, you will be immediately redirected to the form summary/signature page. This form will not be completed until it has been signed at the bottom of that page (next to the big blue arrow). If you have any issues, please contact info@triumph-foundation.org

CAPTCHA

Hidden

Hidden: Form Date