IN CONSIDERATION for being permitted to participate in the Summer Camp Program and other meetings, conventions, activities, and events hosted and/or sponsored by Missouri Council of the Blind (“the Events”)
- HEREBY RELEASES, WAIVES, HOLDS HARMLESS, AND COVENANTS NOT TO SUE Missouri Council of the Blind, its officers, directors, employees, members, volunteers assisting in any way with the Events, Missouri Council of the Blind’s related entities, and any owners and lessees of the premises used to conduct the Events (all of whom are collectively for the purpose herein referred to as “releasees”) from all liability to the Participant, his/her personal representatives, assigns, heirs, and next of kin for any and all loss, illness, injury, or damage that is related in any way to the Events, and any claim or demands therefore on account of illness, injury or damage to the person or property, or resulting in death of the undersigned, whether caused by the negligence of the releasees or otherwise while the undersigned is participating in the Events.
- HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, ILLNESS, DEATH OR PROPERTY DAMAGE OR ANY OTHER DAMAGE that may result from participation in the Events or that in any way relates to the Events, whether such claims result from negligence on the part of any or all of the releasees with respect to the Events or any related activities or with respect to the condition, qualifications, instructions, rules, and procedures under which the Events and related activities are conducted, or from any other cause whether due to the negligence of releasees or otherwise.
- HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, ILLNESS, DEATH OR PROPERTY DAMAGE OR ANY OTHER DAMAGE that may result due to the risk that me or a family member or other contact may contract COVID-19 during the ongoing pandemic, whether or not COVID-19 is contracted during or in relation to the Events and regardless of whether or not COVID-19 is contracted as a result of negligence on the part of any or all of the releasees with respect to the Events or any related activities.
I am voluntarily participating in the Events and expressly acknowledge and agree that the foregoing agreement to release and waive is intended to be as broad and inclusive as is permitted by Missouri law and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
I understand and accept that in the course of my attendance at and participation in the Events, film or photographs may be taken, or illustration may be made of me and/or my personal property. I acknowledge and agree that such film/photographs and/or illustrations may be used in any medium by Missouri Council of the Blind and all its related entities and agencies for advertising and promotional purposes in any medium, without compensation to me. I agree that Missouri Council of the Blind has complete ownership of such pictures, photos, video recordings, digital images, audiotapes, and the like, including all copyrights, trademark rights, and other intellectual property rights, and I agree releasees may copy, modify, adapt, reproduce, display, or otherwise disseminate or use such pictures, etc. for any lawful purpose. I hereby release and hold harmless releasees from any liability associated with the pictures, etc. specified above, including the use thereof. I further understand there is no expectation of privacy or confidentiality associated with the pictures, etc. specified above.
Missouri law governs the interpretation of this Waiver and Release and any dispute that may arise out of this Waiver and Release shall be construed according to the laws of the State of Missouri.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE WAIVER AND RELEASE
Participant’s Name (Print):
If Participant is under 18 years old:
Participant’s Name (Print):
Ways to submit this waiver and release:
You may either download this Waiver and Release, print, complete, and mail to the MCB office at:
Missouri Council of the Blind
Summer Camp Program
5453 Chippewa Street
St. Louis, MO 63109
- You may complete the online application below and submit payment securely online via PayPal or credit/debit card.