Please enable JavaScript in your browser to complete this form.Participant Name *FirstLastParticipant Email *Mailing ListYes, sign me up for the mailing listParticipant PhoneUpload a Photo (for Identification) Drag & Drop Files, Choose Files to Upload and a Participant Waiver of Liability and Photo Use Acknowledgement *(1) From time to time, Kick at Darkness, Inc. dba Kick at Darkness (“KAD”) sponsors, co-sponsors, organizes and facilitates certain events (“Events”) and programs (“Programs”) and makes referrals (“Referrals”) to certain providers (“Providers”) and for certain services (“Services”).(2) As a condition precedent to participation in any such Events or Programs, as a volunteer or as an attendee, and to acceptance of any such Referrals as a recipient, the undersigned, on his/her own behalf and on behalf of all persons and entities for whom the undersigned has legal decision-making authority, including without limitation all of the undersigned’s children, wards, other legal dependents, wholly-owned or controlled corporate entities, and trusts and corporate entities for whom the undersigned alone can act as authorized signatory (collectively, the “ReleasingParties”), executes this general release freely, voluntarily, with full capacity to do so, and will full knowledge and understanding of its implications.(3) The undersigned, for himself/herself and for the Releasing Parties, hereby releases and fully discharges KAD, and KAD’s successors and assigns, and the incorporators, organizers, principles, affiliates, parents, subsidiaries, members, governing bodies, officers, directors, employees and agents of each of them (collectively, the “KAD Parties”), from any and all claims, damages, liabilities, duties, responsibilities or obligations of any kind and nature whatsoever, whether known or unknown, accrued or un-accrued, that the undersigned or any of the Releasing Parties, or any of them, mayhave against KAD or any of the KAD Parties, whether legal or administrative, whether based in contract, in tort or in equity, related in whole or in part to any Events, Programs, Referrals, Providers or Services, it being understood andagreed that the undersigned is participating in such Events or Programs and accepting such Referrals at the undersigned’s own risk and will full knowledge and acceptance of the consequences thereof.(4) Such release does not prohibit the undersigned from entering into a written contract or agreement with KAD and/or any of the KAD Parties, whereby KAD and/or any of the KAD Parties, as the case may be, affirmatively assumes certain liabilities, duties, responsibilities or obligations, whereupon such written contract or agreement shall govern and takeprecedence over this general release, but only to the extent clearly and expressly set forth in such written contract or agreement. Such release also does not prevent any legal recourse the undersigned might have against persons orentities other than KAD and the KAD Parties, and the undersigned hereby agrees that any legal recourse in relation to any of the Events, Programs, Referrals, Providers or Services shall be sought solely from such other parties, and notunder any circumstances from any of KAD or any of the KAD Parties.This release shall apply fully with respect to any current and future Events, Programs, Referrals, Providers and Services.Consent *I agree to the waiver of liability and photo useI do not agreeSubmit Share this: Share on Facebook (Opens in new window) Facebook Share on X (Opens in new window) X Share on LinkedIn (Opens in new window) LinkedIn Print (Opens in new window) Print Email a link to a friend (Opens in new window) Email Like this:Like Loading...
