Waiver Form for photo release of minor children

MINOR RELEASE
PARTICIPANT’S NAME:
PROGRAM: Soccer Clinic with Nesquik “CLINIC”
DATE: January 31, 2015
TIME: 12:30 pm – 4:30 pm
LOCATION: Lake Forest Sports Park
Waiver of Liability, Assumption of Risk And Indemnity Agreement
Waiver for Parent and on Behalf of Child:
I, for myself, and for child, my heirs, personal representatives or assigns, and anyone claiming through or
under me do hereby release, waive, discharge, and covenant not to sue Lake Forest Sports Park, AYSO,
Good Solutions Group, Inc, or Nestlé USA, Inc., their parents, affiliates, subsidiaries, shareholders, directors,
officers, employees, and agents (collectively, “Releasees”) for liability from any and all claims including
the negligence of Releasees, resulting in damage or personal injury, accidents or illnesses (including death),
and property loss arising from, but not limited to, my child’s participation in the Clinic, and use of facilities,
premises, or equipment related to the Clinic.
Assumption of Risks: Physical activity like playing soccer, by its very nature, carries with it certain inherent
risks that cannot be eliminated regardless of the care taken to avoid injuries. My child and I (“We”)
understand that any physical activity, such as kicking a soccer ball and doing various soccer related drills,
involves some risk. We acknowledge and understand that he/she is participating in this Clinic at his/her
own risk. We acknowledge that my child is physically capable of participating in the Clinic.
Indemnification and Hold Harmless: We understand and agree that Releasees shall not be liable – and we
hereby expressly waive any claim of liability – for personal/bodily injury or damages – which may occur to
me, my child or any guest of my child, or for any loss of or injury to person or property. This waiver
includes, but is not limited to any loss, damage or destruction of my personal property of that of my child
or my child’s guest(s) and is intended to be a complete release of any responsibility for personal injuries
and/or property loss/damage sustained by me, my child or any guest of my child while on the club
premises, whether using exercise equipment or not.
We agree to indemnify and hold Releasess harmless from any and all liability and damages incurred arising
out of my conduct or activity or that of my child or any other claimant guest using the facilities while my
child or I are on premises insofar as my child, my child’s guests, or I are claimed liable for damages to
others.
Severability: We further expressly agree that the foregoing waiver and assumption of risks agreement is
intended to be as broad and inclusive as is permitted by the law of the State of California and that if any
portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal
force and effect. Likewise, We agree that if legal action is brought, it must be brought in Los Angeles
County, California.
Photography and Videography: In consideration of the opportunity to participate in the Clinic produced
by Good Solutions Group, Inc. on behalf of Nestlé USA, Inc. We agree that any video and photography
produced during the Clinic which may incorporate my child’s or my image and voice, may be broadcast and
distributed without limitation through any means, and we shall not receive any compensation for my
child’s or my participation. We also agree to the use of my child’s or my name, likeness, portrait or
pictures, video, and/or voice, which may be used for any educational, commercial, marketing, advertising,
or promotional purposes. We further agree that my child’s or my participation in the program confers
upon my child and me no rights to use, ownership or copyright. We release Releasees from all liability
which may arise from any and/or all claims by my child, my child’s guest, or me or any third party in
connection with my participation in the Clinic. It is understood that Releasees are under no obligation to
broadcast the above-identified program(s) or video series.
ACKNOWLEDGMENT OF UNDERSTANDING:
This release applies to any and all injuries, damages or losses, whether known or unknown, foreseen or unforeseen,
which may arise in any way pertaining to the subject claim. I expressly waive the provisions of Section 1542 of the
California Civil Code, which provides as follows:
"A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR
SUSPECT TO EXIST IN HIS FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY
HIM MUST HAVE MATERIALLY AFFECTED HIS SETTLEMENT WITH THE DEBTOR."
I understand and acknowledge the significance and consequence of the waiver of Civil Code Section 1542.
I HAVE READ THIS WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, FULLY
UNDERSTAND ITS TERMS, AND UNDERSTAND THAT MY CHILD AND I ARE GIVING UP SUBSTANTIAL
RIGHTS. I ACKNOWLEDGE THAT I AM SIGNING THE AGREEMENT FREELY AND VOLUNTARILY, AND INTEND
MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST
EXTENT ALLOWED BY LAW.
____________________________________________________
Participant Name
I,
am the parent or legal guardian of the above-named
minor and I endorse the above statement in his/her behalf on this____day of
, 2015.
Parent or Guardian signature
Date