Liability Waiver

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Name of event*

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

Name*

DOB*

Email*

Phone*

Address*

Veteran?*

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Gender*

Are you a person with a disability?*

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Disability Type*

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Injury Description*

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Date of injury/diagnosis*

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Cause of injury*

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

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Tell us more

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Is this your first Triumph Event?*

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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.

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:

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.

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

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