Assumption of Risk and Release of Liability for Bodily Injury and Loss or Damage to Property

I, ______________________________________________, hereby acknowledge that I have voluntarily elected to participate in the project(s) and/or event(s) of the Howard T. Odum Florida Springs Institute occurring at any time or place between January 1, 2019, to December 31, 2019. I am aware that certain risks and dangers may arise, including, but not limited to: (1) hazards of travel by various conventional and primitive modes, including travel in mountainous or wilderness terrain, at high altitudes, over water, or in undeveloped areas; (2) hazards of nature, including injury and/or death from animal attack, illness or injury from water, insect or food borne bacteria or viruses, and hypothermia, heat exhaustion and stroke, and other illness or injury due to exposure to the elements, or due to physical exertion; and (3) man-made hazards, including  acts of civil unrest,  terrorism, or other intentional or accidental acts resulting in injury or illness in remote areas without ready access to means of evacuation or modern medical facilities or supplies.  I expressly acknowledge and agree that Florida Springs Institute, and their staff, affiliates, volunteers, and private providers of services and/or equipment are not liable for my personal safety or the adequacy of any medical care, equipment or supplies that may be provided to me in the event of illness or injury.

I represent that I am physically and mentally prepared for the rigors of activities related to the project(s) and/or event(s) and that I have been cleared by my physician to participate.

I AM VOLUNTARILY PARTICIPATING WITH KNOWLEDGE AND APPRECIATION OF THE RISK OF INJURY INVOLVED, AND HEREBY AGREE TO BE SOLELY RESPONSIBLE FOR MY OWN WELFARE.  I EXPRESSLY AND KNOWINGLY ASSUME ANY AND ALL RISKS OF ILLNESS AND INJURY, INCLUDING DEATH, AND HEREBY RELEASE AND DISCHARGE THE FLORIDA SPRINGS INSTITUTE AND ITS AGENTS, EMPLOYEES AND REPRESENTATIVES FROM ALL CLAIMS OR DEMANDS FOR DAMAGES RESULTING FROM MY PARTICIPATION IN PROJECTS(S) AND/OR EVENT(S).  I agree that the foregoing obligation shall be binding upon me personally, as well as upon my heirs, executors and administrators, and all members of my family, including any minors accompanying me.  I have read carefully this agreement and fully understand its contents.  I am aware that this is a release of liability and sign it of my own free will.   I also acknowledge that I have been given a copy and have read carefully all project and/or event itinerary and agree to all the stated conditions set forth there within.

Full Name (Print) ___________________________________________________

Signature____________________________            Date____________________________

If this release is obtained from an individual under the age of 18, then the signature of that individual’s parent or legal guardian is also required.

Parent’s Signature_____________________ Date____________________________

 


 

Photography & Video Release Form

I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording.  I also understand that this material may be used in diverse educational settings within an unrestricted geographic area.

Photographic, audio, or video recordings may be used for the following purposes:

  • Future event promotion
  • Educational presentations or courses
  • Informational presentations
  • On-line educational courses
  • Educational videos

By signing this release, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting.

I will be consulted about the use of the photographs or video recording for any purpose other than those listed above.

There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

This release applies to photographic, audio, or video recordings collected as part of events hosted by the Howard T. Odum Florida Springs Institute.

By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational and outreach purposes.

Full Name (Print) ___________________________________________________

Signature____________________________            Date____________________________

If this release is obtained from an individual under the age of 18, then the signature of that individual’s parent or legal guardian is also required.

Parent’s Signature_____________________ Date____________________________

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