Emergency Contact
Relationship to Attendee
Address
City/Zip / Phone
Student’s School
Please note:
- This form must be completed and signed by Parent/Legal Guardian, and hand carried to the Dare 2B Digital Conference on Feb 27, 2016.
- No student will be admitted to the event without a signed form. Signed release forms must be handed in at registration before registration can be processed.
- Please make sure the name on the form matches the name of the student registered.
1. Consent to Participate
I hereby give my permission for my child/wardto participate in the 2016Dare 2B Digital Conferenceand Innovation Challenge. In case of an emergency and should I not be reached, I authorize the conference, Invent Your Futurepersonnel and medical personnel to grant medical treatment for my child. The Conference strongly recommends that parents carry health or accident insurance for their child.
2. Incidental Use of Audio, Video, Photo.
The Dare 2B Digital Conference and Innovation Challenge may elect to record the presentations and remarks made by speakers and other activities occurring at the Conference, and to edit and use the same, for education purposes consistent with the overall purpose of the Conference, including promotional activities for future Events. While any such activity would be primarily directed to the recording of presentations and remarks of conferences speakers, it is possible that such activities may include incidental recording of the image, speech or likeness of me and my child/ward, including the recording of any comments, questions or remarks made by myself or mychild/ward. We (I, my child/ward and our families) therefore grant permission to the Conference and Innovation Challenge and its assigns to make mention of and to record audio and visual likenesses of myself and mychild/ward, and to edit, modify and use the resulting sounds and images in any manner consistent with the purposes articulated above and the overall purpose of the Conference and Innovation Challenge. Inspection or approval of any recording or written copy or other transcription is waived.
3. Release and Waiver of Claims.
In order for myself and/or mychild/wardto participate in the Dare 2B DigitalConferenceand Innovation Challenge, weeach hereby waive and release any and all claims against the Conference (including Invent Your Future Enterprises, the venueand their agents, officers, vendors, volunteers and employees), for injury, accident, illness or death occurring during or by reason of her participation in this Conferenceand Innovation Challenge.This release encompasses all claims, demands, actions, causes of actions, suits, damages, losses, costs, attorneys’ fees and /or expenses, known or unknown, which we may claim to have to against the Conference or arising from presence on any facility where the Conference is conducted and we hereby promise not to assert any such claims, demands, actions or causes of actions. We expressly waive and relinquish all rights and benefits afforded by Section 1542 of the Civil Code of the State of California, which states as follows:
"A general Release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the Release, which if known by him must have materially affected his settlement with the debtor."
Thus, notwithstanding Section 1542, we acknowledge that this release extends to all claims including those which we do not know at the time of execution, and that release extinguishes of any and all such claims. We acknowledge that the only consideration for signing this release is the terms stated herein and the ability of myself and mychild/ward to attend the conference, and that no other promise or agreement of any kind, verbal or otherwise, has been made to or with me by any person or entity whomsoever to cause me to execute this Agreement.
We promise never to file a lawsuit asserting any claims that are released in this Agreement. If we break this promise and file such a lawsuit, we will pay for all costs incurred by Invent Your Future Enterprises, including reasonable attorneys' fees, in defending against my claim. Furthermore, we shall indemnify, protect, save and keep harmless the Conference, Invent Your Future Enterprises, the venue, its agents, officers, volunteers and employees from and against damages, including legal expenses and attorney fees, of whatsoever nature arising out of her participation in said activity. We acknowledge that participation in this activity is voluntary. The duty to indemnify and keep harmless set forth herein shall include the duty to defend as established in Section 2778 of the California Civil Code, and the duty to defend shall arise upon the making of any such claim against the Conference, Invent Your Future Enterprises, eBay, their agents, officers, volunteers and employees, notwithstanding that no determination of the underlying facts has occurred.
☐By completing and submitting this Parental Consent Form, I am allowing my child/minor to participate in the 2016 Dare 2B Digital Conference and Innovation Challenge. I certify that I am at least 18 years old and that I am the parent or legal guardian of such child/minor.
☐I have read and agree to the Official Rulesof the 2016 Dare 2B Digital Conference and Innovation Challenge.
☐I have read and agree to the Privacy Policy and the Terms of Use of the 2016 Dare 2B Digital Conference and Innovation Challenge.
I understand and agree to the above:______Date:______
Name: (please print)______
P.O. Box 1206 | San Carlos, CA | 94070