2022 Inland Empire Senior Games Application

2022 INLAND EMPIRE SENIOR GAMES

City of San Bernardino Waiver

PHOTO & FILM WAIVER: I hereby grant permission to the City of San Bernardino, its employees, agents, officers, affiliates, elected officials, successors, and assigns (herein collectively referred to as “ City ”), the right, but not the obligation, to use my name, photograph, video, audio, likeness, voice, appearance, statement, biographical information, and any other personal characteristics as may be embodied in any visual images and/or audio sound supplied by me to, or taken of me by, the City and the Inland Empire Senior Games. I agree that the City owns the image and/or audio and all rights related to them without limitation. The images and/or audio may be used in any and all matter of media without notifying me, for any purpose consistent with the City ’ s publicity objectives. By signing below, I am at least 18 years of age, and am competent to sign this release. I have read the release before signing, I understand its contents, meaning and impact, and I freely accept the terms. LIABILITY WAIVER: I, the undersigned participant, hereby agree to indemnify and hold harmless the organizers of the Inland Empire Senior Games (IESG), hereinafter sometimes referred to as sponsor, their agents, employees, and representatives and assigns, from any and all action or claims of whatsoever kind or nature which I or my representatives or assign may have or at any time in the future have due to any injury or property damage arising out of my participation in the IESG. I understand and agree that any dispute over injury or property damage caused by myself or another participant must be settled between the individuals. I warrant and represent to the organizer, that I have prepared myself for the event(s) which I have entered by practicing the same prior to my participation. I warrant and represent that I am in good physical health and condition; I am physically able to compete in the event(s), and know of no physical restriction whatsoever which would prohibit my participation on the IESG. I have been advised by the organizer that it would be in my best interest to consult a physician prior to my preparation for participation in this event. I recognize and understand that preparation and competition may necessitate strenuous physical activity and could possibly activate an unrecognized preexisting health conditions which I may have, thereby resulting in serious or life threatening physical harm to me. The organizer has my permission to have a physician treat me during my participation in the IESG.

*EVENTS, VENUES SITES, AND TIMES ARE SUBJECT TO CHANGE WITHOUT NOTICE.*

I have read this document, I understand it is a release of all claims and I assume all risks inherent in this event.

Print_______________________________________

Signature_______________________________________ Date_________________________

WAIVER MUST BE COMPLETED PRIOR TO START OF TOURNAMENT

GAMES FORM (PAGE 3)

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