This is an Agreement between Hearts and Minds
Network, Inc. and all individual(s) specified below.
I, ______________________________, am at least 18 years old. I am
also the parent/legal guardian of any other individuals listed below.
I hereby give full permission for myself and my child(ren)/ward(s)
(referred to here as "we" and "us") to participate in programs run by
Hearts and Minds Network, Inc., its partner organizations, its licensees and assignees
(collectively referred to as "Hearts & Minds" and "them").
We give Hearts & MindsSM permission to use
our name
and interviews, photography, film, audio and video of me (or in which
we may be included) taken during the events (collectively, the "Released
Words and Images") in any promotional materials.
We also grant irrevocable and unrestricted right to
use and publish Released Words and Images, for editorial, trade,
advertising and any other purpose in any manner and medium; to alter the
same without restriction; and to copyright the same. We hereby release
Hearts & Minds and their legal representatives and assigns from all
claims and liability relating to said Released Words and Images. Hearts & Minds reserves the right to decide the manner
in which any credit is provided.
We grant to Hearts & Minds the foregoing exclusive rights
regarding the Released Words and Images in any and all media now or hereafter known,
including but not limited to any print publication, video, film, telecast, exhibition,
website and digital reproduction.
The Released Words and Images can be used for illustration, art,
promotion, public relations, fundraising, advertising, trade, stock photography, promotion
of any goods or services, or any other purpose whatsoever.
We acknowledge that Hearts & Minds is and shall be
considered the author of
all Released Words and Images under all applicable copyright laws whether foreign or
domestic and owns and shall own all Released Words and Images in all forms. If there is a
conflict between any applicable laws or an absence of comparable laws, those of the United
States of America will apply.
If anyone makes use of our words or images in a way that is not
authorized by Hearts & Minds and that we find deeply objectionable, we can take
appropriate legal action against only those unauthorized parties. We will
continue to hold
Hearts & Minds completely harmless and free of liability, and will take no actions against Hearts & Minds,
nor require its participation in our independent legal actions.
We are in good health and We know that
We can drop out any time during the Walkathon. We hereby release, discharge and agree to hold Hearts & Minds
harmless from any liability resulting from any injury or accident, regardless of cause, in
which we are involved before, during or after any events or other meetings with Hearts & Minds.
In addition to the absolute and unqualified
release from all liability, We hereby represent that we are physically
capable of participation in this event. We will observe all applicable
laws, traffic and event rules and conduct ourselves in a safe and
prudent manner while participating in Hearts & Minds events. We
understand that we are free to discontinue participating at any time and
that decision is our responsibility.
We hereby consent to and permit emergency
treatment in the event of injury or illness while participating in this
event.
If any disputes arise regarding this Agreement, both parties will
make every reasonable effort to resolve them by mutually acceptable, impartial conflict
resolution. If they cannot agree on an arbitrator, all conflicts shall be resolved
according to the laws of New York State and shall be brought before the courts of that
state in a location convenient to the Hearts & Minds office.
This Agreement constitutes the entire Agreement between the parties
with respect to the subject matter hereof and shall supersede all previous communications,
representations, understandings and agreements, either oral or written, between the
parties or an official or representative thereof. This Agreement can only be modified in
writing and only when signed by both parties.
This entire Agreement shall inure to the benefit of Hearts &
Minds, its agents, licensees, representatives and assigns and shall be binding upon us and
our heirs, legal representatives, heirs and assigns. If any part of this Agreement is found to be
unenforceable, all remaining provisions shall remain in force.
WE HEREBY AFFIRM that
we
have read carefully this Release
Authorization and Agreement to Hold Harmless
prior to its execution. We had an opportunity
to have all of our questions answered completely and to fully consider
this Agreement. We completely understand and fully agree to the contents
thereof.
I, the one who signs the first line below, am at least 18 years of age and have the legal right and
authority to contract for this Agreement for myself and any minors named
herein. We hereby release Hearts and Minds Network, Inc. from any claim
or liability whatsoever in connection with our participation in any
activities with Hearts & Minds, the use of artwork, film, other
intellectual property and accompanying disclosures.
