JIMMY MILLER MEMORIAL FOUNDATION WAIVER OF LIABILITY / EXPRESS ASSUMPTION OF RISK / PHOTO & VIDEO RELEASE AGREEMENT
(PLEASE READ CAREFULLY)
I HEREBY CERTIFY THAT I AM AWARE OF THE INHERENT HAZARDS AND RISKS OF THE EVENT I AM PARTICIPATING IN. EVENT: The Jimmy Miller Memorial Ocean Therapy Program, hereby referred to as the “Event.”
I agree as follows: 1. I am participating in the Event on my own free will and am aware of the inherent risks, hazards and possible danger of participating in the event, including possible death; 2. I will act within my physical capability to the best of my ability, and I will not undertake tasks that are beyond my ability; 3. I am familiar with the safe operation and use of equipment and tools that I may utilize in connection with this activity, and I will not undertake to use any equipment or tools with which I am unfamiliar or do not know how to operate safely; 4. I acknowledge that I have received and read appropriate instruction regarding this Event, including appropriate safety and emergency procedures; 5. I will observe all safety rules; 6. I specifically acknowledge that I am engaging in this activity on my own free will, that I am of sound mind and body; 7. I acknowledge that I am not entitled to any compensation, benefit or insurance coverage from the State of California, the Department of Parks and Recreation, the California Coastal Commission, the City of Los Angeles, The Department of Beaches and Harbors, the United States Marine Corps, USMC Base at Camp Pendleton, the Wounded Warrior Battalion-West, the Warrior Foundation Freedom Station, Veterans Village San Diego, the Jimmy Miller Memorial Foundation, Pure Surfing Experience or any Event promoter or sponsor, nor will I make any such claim. 8. I acknowledge that surfing carries a degree of risk that no amount care, caution, instruction, expertise can completely eliminate.
I understand and agree that neither the State of California, California Coastal Commission, California Department of Parks and Recreation, City of Los Angeles, LA County Department of Beaches & Harbors, the United States Marine Corps, USMC Base at Camp Pendleton, the Wounded Warrior Battalion-West, the Warrior Foundation Freedom Station, Veterans Village San Diego, the Jimmy Miller Memorial Foundation, Pure Surfing Experience, Inc. nor any other organizers or promoters or sponsors or property owners involved in this event, nor any of their respective employees, officers, directors, agents or assigns, (hereinafter collectively referred to as “Released Parties”), may be held liable or responsible in any way for any injury, death or other damages to me or my family, heirs, or assigns that may occur as a result of my participation in this activity, or as a result of product liability or the negligence of any party, including Released Parties, whether passive or active.
I understand that participating in this Event involves certain inherent risks, including but not limited to, the risks of possible injury, infection or loss of life. Despite these risks, I still choose to proceed in such activity. I know of no physical limitation that should keep me from undertaking the activities associated with this Event. In consideration for being allowed to participate in this activity, I hereby personally assume all risks in connection with the Event for any harm, injury or damage that may befall me as a participant, including all risks connected therewith, whether foreseen or unforeseen.
Further, I understand that the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I and my child(ren) may be exposed to or infected by COVID-19 by attending and participating in the Event and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Event may result from the actions, omissions, or negligence of myself and others, including, but not limited to, JMMF employees, contractors, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself and my child(ren) (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my or my child(ren)’s attendance at the Event or participation in JMMF programming (“Claims”). On my behalf, and on behalf of my children, assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives, I hereby release, covenant not to sue, discharge, and hold harmless the State of California, California Coastal Commission, California Department of Parks and Recreation, City of Los Angeles, LA County Department of Beaches & Harbors, the United States Marine Corps, USMC Base at Camp Pendleton, the Wounded Warrior Battalion-West, the Warrior Foundation Freedom Station, Veterans Village San Diego, the Jimmy Miller Memorial Foundation, Pure Surfing Experience, Inc. and any other organizers or promoters or sponsors or property owners involved in the Event, and any of their respective employees, officers, directors, agents or assigns, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Jimmy Miller Memorial Foundation, its employees, contractors, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in the Event or any program offered by the Jimmy Miller Memorial Foundation.
If I should become injured while participating in the Event, I authorize any physician or surgeon licensed in the State of California to perform emergency or surgical treatment as in his or her sole judgment may be necessary. I further declare that I am eighteen and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. I understand that the terms herein are contractual and not a mere recital, that this instrument is a legally binding, and that I have signed this document of my own free act.
BY THIS INSTRUMENT I DO HEREBY EXEMPT AND RELEASE ALL “RELEASED PARTIES,” AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, INFECTION, PROPERTY DAMAGE OR WRONGFUL DEATH, HOWEVER CAUSED, INCLUDING NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE.
PHOTO & VIDEO RELEASE
By participating in this Event, I understand that photography, filming, video and audio capturing may be taking place and I hereby grant to the Jimmy Miller Memorial Foundation, its agents, sponsors, partners and their respective licensees, successors and assigns (herein collectively called the “licensed parties”) the right to use, publish and copyright my name, image on video and film, picture, portrait, voice and likeness in advertising, promoting and publicizing the Jimmy Miller Memorial Foundation in manner or form throughout the world in any form currently in existence or developed in the future, worldwide and in perpetuity.
I agree that any picture/video taken of me and/or any recording of my voice by the licensed parties is owned by them and I am not owed any form of compensation. I further agree that no advertisement or other material need be submitted to me for any further approval and the licensed parties shall be without liability to me for any distortion or illusionary effect resulting from the publication of my picture, portrait, voice or likeness.
I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY AND ASSUMPTION OF RISK, PHOTO AND VIDEO RELEASE BY READING IT BEFORE I SIGNED IT ON BEHALF OF MY HEIRS AND MYSELF.
Participant's Name *
Date *
IF PARTICIPANT IS UNDER 18, THE PARENT(S) (OR GUARDIAN(S), IF ANY, MUST SIGN. The above participant has my permission to participate in this Event. I have read and agree to the provisions stated above. I know of no limitations that may restrict this volunteer’s participation in this activity.
Dear Parent/Guardian,
Thank you for allowing your child to volunteer with the Jimmy Miller Memorial Foundation (JMMF). We value the contributions of young volunteers and want to ensure their safety and well-being. Please read and sign the following waiver to grant permission for your child to participate in our volunteer activities.
Waiver and Release of Liability:
I, the undersigned, certify that I am the parent or legal guardian of the volunteer with this form and that I have legal authority to sign this waiver on their behalf.
I understand that my child will be participating in volunteer activities with JMMF, which may include but are not limited to water safety, surf instruction and assisting with activities for the session on the beach as well as handling of the equipment from the parking lot to the sand. I acknowledge that these activities may involve certain risks, including but not limited to physical injury, illness, or other unforeseen incidents.
In consideration of my child being allowed to participate in these activities, I hereby agree to the following:
I grant permission for my child to volunteer with JMMF.
I assume all risks associated with my child's participation in these activities.
I release, waive, and discharge JMMF, its officers, employees, and agents from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained by my child while participating in volunteer activities.
I agree to indemnify and hold harmless JMMF from any claims, damages, injuries, or expenses arising from or related to my child's participation in volunteer activities.
I understand that JMMF does not provide medical insurance coverage for my child and that any medical expenses incurred as a result of my child's participation are my responsibility.
Consent to Medical Treatment:
In the event of an emergency, I authorize JMMF to obtain necessary medical treatment for my child. I understand that every effort will be made to contact me before any treatment is administered.
By clicking the box, I acknowledge that I have read and understand this waiver and release of liability. I agree to the terms and conditions stated above and give my consent for my child to participate in volunteer activities with JMMF.
