Young Movers Conference 2018 – Brussels
This form must be completed for each conference participant. No participant will be allowed to take part of the Young Movers Conference 2018 without this form, properly executed, and on file.
PARTICIPANT’S MONTH AND YEAR OF BIRTH:
I, the undersigned, in consideration for my voluntary participation in this organized conference and outdoor activities, do hereby willfully acknowledge that my signature below attests to my understanding and agreement that:
My participation in this organized conference will be kept in good standing. I will not compromise myself in such a way as to do harm to the event, knowing that participants may be dismissed from participation, with possible loss of payment or dues, for violent conduct, inappropriate or unsportsmanlike behavior. I agree to pay for any and all damages to any property or any persons or indemnities caused by me willfully, negligently, or otherwise.
The outdoor activity I have selected during my participation may include high-risk sport and might involve contact with other people that involve the risk of injury. I assume all risks and hazards associated with my participation. I am in proper physical condition to participate in the conference and specifically in the outdoor activity selected and have no illness, disease or existing injury or physical defect that would be aggravated by my participation. I will inform the organizers if this status changes. I further acknowledge that this risk may involve loss or damage to me or my property, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. I have a current medical consent form in force. During the outdoor activities, if instructed, I will wear approved safety gear; i.e. helmet with face shield or goggles, full finger gloves, appropriate protective suit (or similar per-approved attire), and protective shoes, as provided by the venue vendors, to the event.
The conference does not have personal injury insurance that covers my participation. Therefore, I should have a current, active, personal injury insurance policy in force, which covers my participation. Under any condition, I am responsible for any and all medical expenses’ arising from my participation in the race and while traveling to and from this event. I have the right and responsibility to inspect the equipment and facilities prior to events and, if I believe that anything may be unsafe, I will advise the organizers of the condition and may refuse to participate. Participation assumes consent.
I authorize my photograph, picture or likeness, and voice to appear in any documentary, promotion (including advertising), television, video, or radio coverage of the event, without compensation.
I hereby release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue the organizing Company – Young Movers Conference 2018 LLC, The YMC 2018 Organizing Committee, FEDEMAC & IAM, the sponsors, the race, their associated directors, administrators, officers, managers and employees from any and all liability incurred in the conduct of, and my participation in, this event. This includes owners, lessors, and lessees of premises, municipalities, government agencies, successors, heirs, and assigns.
I have completely read this document and fully understand its contents. I acknowledge that I have given up substantial rights by accepting this document and that I do so voluntarily. My signature attests to this on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin, successors, and assigns.
Signature Date and Place
Please download the Waiver-2018 PDF format, fill it out with your name and birth date, sign, scan and sent it back by email to firstname.lastname@example.org