RELEASE AND WAIVER OF LIABILITY FORM
I wish to participate in the Special Olympics New Jersey Young Athlete’s Program (“Program”) being held on October 24, November 7, 21, and December 5 at Kean University, 1000 Morris Avenue, Union, New Jersey. I understand and appreciate the dangers, hazards and risks inherent in my participation in the Program and voluntarily assume all such dangers, hazards and risks, including those that may result in injury to myself or my property. I agree that neither Kean University, the State of New Jersey and any trustee, director, officer, agent, employee, member, volunteer or any other representative of Kean University, the State of New Jersey, nor any of their respective successors or assigns (collectively, “Kean”) shall be liable for any loss, damage, injury (including death) or claim of any kind to person or property arising from or caused by my participation in the Program, including without limitation, any loss, damage or claim arising from an accident, injury or casualty involving me whether or not on or off Kean’s property. I further agree to indemnify, defend and hold harmless Kean from all loss, liability, damages, claims, costs and expenses (including court costs and actual attorney’s fees) arising from or related to same. I further agree to abide by Kean’s rules, regulations and directives governing the use of Kean’s facilities. This Release and Waiver is intended to be as broad and as inclusive as permitted by the laws of the State of New Jersey. If any portion of the Release and Waiver is declared invalid, I agree that the remainder of the Release and Waiver will continue to be applicable. This Release and Waiver is binding on my heirs, spouse, parents, guardians, executors, administrators and/or assigns. I am at least eighteen (18) years of age, or, if not, have secured below the signature of my parent or guardian, as well as my own, and am fully competent to sign this Release and Waiver. I execute this Release and Waiver for full, adequate, and complete consideration, fully intending to be bound by the same, and I will be responsible to pay any medical costs that may occur as a result of any illness or injury to me. If illness or injury should occur during my participation in the Program, I authorize Kean to provide medical treatment at an appropriate medical facility. I will not hold Kean, its employees and agents responsible for the kind and quality of emergency medical treatment received by me.
I further consent to and authorize Kean University, its officers, agents, employees and assigns to:
a) Record my likeness and voice on a video, audio, photographic, digital, electronic, print, and any other medium.
b) Use my name in connection with these recordings.
c) Use, reproduce, exhibit, and distribute in any medium (e.g. print or web publications, productions, news releases) these recordings for any purpose that Kean and its representatives deem appropriate, including promotional or advertising efforts.
I release Kean and its representatives from liability for any violation of any personal, privacy, or proprietary right I may have in connection with such use. I understand that all such recordings, in whatever medium, shall remain the property of Kean. I waive the right to inspect or approve the finished product in which my likeness appears and I acknowledge that no monetary consideration is being paid to me for my appearance, likeness, statements or recordings.
In signing this Release and Waiver, I acknowledge and represent that I have carefully read same, that I understand its contents, and that I sign this document of my own free will. I am aware that important rights are being released and given up.
I certify that I am the parent or legal guardian of the above participant, that I have read the foregoing Release and Waiver. I join in each and every part of the Release and Waiver (including such parts as may subject me to personal financial responsibility for the participant), and release any claim that I may have against Kean, both on my own behalf and in my capacity as legal representative of the participant, including without limitation any claim arising as a result of the participant’s leaving the supervision of Kean.