I am Fearless I am Awesome I am, Lauren's House 4 Positive Change- sharing God's love
I am Fearless I am Awesome I am, Lauren's House 4 Positive Change- sharing God's love

Participation Form

Personal Info

Liability Waiver

By signing below, and in consideration of my child being permitted to participate in the after school program and outing, I understand and agree as follows:

I am fully aware that participation in may result in risk of personal injury or harm to my child. I hereby agree to release and hold harmless the Lauren’s House 4 Positive Change Inc (Lauren’s House). its, officers, employees, volunteers, committees and boards, from and against any and all liability, loss, damages, claims, or actions (including costs and attorneys fees) for bodily injury and/or property damage, to the extent permissible by law. I understand and agree that no oral or written representations can or will alter the contents of this document.

This indemnification and hold harmless agreement shall include indemnity against all costs (including without limitation, reasonable attorney’s fees and court costs), expenses and liabilities incurred in or in connection with any such claim or proceeding brought thereon and in defense thereof.

I have read and understand this release, indemnification and hold harmless form. I voluntarily sign it and hereby give permission to Lauren’s House for emergency transportation and/or treatment in the event of illness or injury. I hereby accept responsibility for the payment of any emergency transportation and/or treatment. I further certify that my child is in good physical condition, and has no medical or physical conditions that would restrict his/her participation in this activity or program. I have medical coverage for my child and that information has been provided to Lauren’s House staff.

Photo Release

In consideration of my child’s participation at Lauren’s House and without any further consideration from Lauren’s House, I hereby grant permission to Lauren’s House, staff and affiliates to utilize my appearance, performance or voice in any and all manner and media throughout the world for the purpose of promotion, reporting or publication. Lauren’s House may use my child’s name, likeness, voice and biographical material in connection with the publication, promotion, exhibition and distribution of such material. I understand that no royalty, fee or any other compensation of any kind shall become payable to me by reason of such release and use of any photograph.