Participant
Waiver of Liability and Release
My signature on
this form signifies that I have read, understand, and will abide by this
information.
On behalf of
myself, my executors, administrators, heirs, next of kin, successors and
assigns, and anyone else who might sue on my behalf, I hereby waive, release
and forever discharge Games Media
Properties, all
Event producers, staff officials, contractors, vendors, organizers, Event
administrators, sponsors, volunteers, all other persons or entities involved in
the Event, the state, cites, town and other governmental bodies and locations
in which the Event or portions of the Event take place, and all their
affiliated entities, employees, agents, representatives, and directors thereof
(all collectively known as “Event Organizers”) from all claims, actions, suits
and demands whatsoever in law or in equity, including, but not limited to,
death or injury from participating in the Event, the risk of loss of personal
property by theft or otherwise, including any claims for the provision of first
aid, medical care, medical treatment or medical decisions and I further agree
to indemnify, defend and hold harmless the Event Organizers from any and all of
the above such claims, actions, suits and demands.
Further, I hereby
grant full permission for the Event Organizers to record any or all of my
participation, my name and likeness in the Event for photos, motion pictures,
TV, radio, Internet, recordings, videotapes, and other media known or unknown,
and to use them in perpetuity, no matter by whom taken or recorded, in any
manner for publicity, promotions, advertising, trade or commercial purposes,
without any reimbursement of any kind due to me, or the need to pay me any fee
whatsoever. I agree that GAMES MEDIA
PROPERTIES, Inc. will be the exclusive owner of all rights, including but not
limited to the copyrights, in and to the recordings and the results and
proceeds of my participation hereunder (“Materials”). I agree that the
Materials shall
constitute a “work made for hire” pursuant to the United States Copyright
Act. To the extent any of the Materials
are not considered a “work made for hire,” I hereby assign all rights in the
Materials to GAMES MEDIA PROPERTIES, Inc.; such assignment shall be deemed irrevocable
and coupled with an interest.
I represent and
warrant that (CIRCLE ONE): I AM / I AM NOT at
least 18 years of age.
SIGNATURE: _____________________________
PRINT
NAME: _____________________________
ADDRESS: ________________________________
PHONE: ________________________________
EMAIL: ________________________________
If participant is
under 18 years of age, parent or guardian must also sign below:
I represent that I am a
parent/legal guardian of the minor named above and I agree that the grant and
release contained above binds us and said minor to all of the terms thereof.
PARENT/GUARDIAN
SIGNATURE: _____________________________
PRINT
NAME: _____________________________
ADDRESS: _____________________________
PHONE: _____________________________
EMAIL: _____________________________