PARTICIPANT’S RELEASE, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

The undersigned participant, hereby represents and warrants that he/she hereby requests permission to participate in the events and activities offered with Limb Loss Education Day (LLED) sponsored by the Amputee Coalition, and held at Kessler Institute for Rehabilitation, Inc., located at 1199 Pleasant Valley Way, West Orange, New Jersey 07052. The undersigned is permitted to participate in any and all events and activities which may be offered including but not limited to various instructional physical clinics and activities, educational clinics and meetings, and wellness clinics (collectively, “Activities”). The undersigned participant will hereinafter be referred to as “I”, “Me” or “My”.

In consideration of the grant of permission by Amputee Coalition to participate in the Activities, I, on my own behalf and on behalf of My personal representatives, heirs, next of kin, spouse, agents, executors, successors and assigns, do hereby:

1. RELEASE, ACQUIT, FOREVER DISCHARGE, AGREE TO HOLD HARMLESS AND COVENANT NOT TO SUE AMPUTEE COALITION AND KESSLER INSTITUTE FOR REHABILITATION, INC., and any sponsors, their officers, directors, shareholders, trustees, employees, volunteer workers, agents, representatives, affiliates, heirs, predecessors, suppliers, successors and assigns (all of whom are hereinafter collectively referred to as “Releasees”), from any and all rights, claims, demands, actions, liabilities and causes of action, whether accrued or unaccrued, fixed or contingent, legal or equitable, arising out of strict liability or the ordinary negligence of Releasees or any other participant in the Activities, and which in any manner relate to any act engaged in by Me while participating in the Activities or while on the premises of the Property, which causes Me personal or bodily injury, death, damages or property damage.
2. UNDERSTAND, ACKNOWLEDGE AND AGREE: (i) that My participation in the Activities may include INHERENT DANGER AND RISK OF INJURY OR DEATH TO ME; (ii) that conditions on the Property may change from time to time and may become more hazardous; and (iii) that there is INHERENT DANGER in participation in Activities of this nature, which risk and danger I understand, appreciate and voluntarily assume because I choose to do so. I represent and warrant that I have observed these types of Activities or events of the type that I seek to participate in, and I understand and agree that the Property and the structures and equipment used in connection with the Activities, the access ways or lack thereof, lighting or lack thereof, and weather conditions all can change and pose a danger to Me. I further understand that other participants could pose a danger to Me. Nevertheless, I VOLUNTARILY ELECT TO ASSUME AND ACCEPT ALL RISKS connected with My participation in any of the Activities and/or other acts of any nature while on the premises of the Property.
3. AGREE TO INDEMNIFY, DEFEND AND HOLD RELEASEES HARMLESS from any claim, judgment, loss, liability, damage or costs, including reasonable attorney’s fees and expenses, which may be brought by any person which is due to any act or omission by Me in any manner relating to or arising out of My participation in the Activities or any other acts that I may be engaged in while upon the premises of the Property whether caused or contributed to by the negligent acts or omissions of the Releasees or otherwise.
4. AGREE TO ALLOW AMPUTEE COALITION-CREDENTIALED PHOTOGRAPHERS AND MEMBERS OF THE PRESS to take My photograph and to produce video and/or audio recordings of Me. I understand that only Amputee Coalition-credentialed photographers and the members of the press are sanctioned to take photographs and/or produce video and/or audio recordings of any kind or with any device. Amputee Coalition-credentialed photographers and members of the press will be identified by a press badge. I further authorize the use of my photograph, image, likeness, name and/or voice in any format for publicity, education and/or marketing purposes associated with the Amputee Coalition, its programs, publications and/or materials. I hereby grant the Amputee Coalition all copyright and other interests in photographs, video recordings and audio recordings of Me produced at or in conjunction with LLED and related Activities and grant royalty-free permission to the Amputee Coalition to reproduce and use photographs, video recordings and audio recordings of Me in all formats, including but not limited to print and/or electronic. This authorization extends to releasing My photograph, image, likeness, name and/or voice to other publications and organizations for Amputee Coalition publicity, education and/or marketing purposes.
5. I UNDERSTAND, ACKNOWLEDGE AND AGREE THAT AMPUTEE COALITION MAY NOT BE ABLE TO PREVENT unauthorized persons from taking photographs, video recordings and/or audio recordings of Me without My permission. Nevertheless, I VOLUNTARILY ELECT TO ASSUME AND ACCEPT ALL RISKS of an unauthorized individual taking photographs, video recordings and/or audio recordings of Me without My permission, and I agree to hold Releasees harmless and covenant not to sue Releasees for the dissemination of such unauthorized photographs, video recordings and/or audio recordings.