1. VOLUNTARY APPLICATION, ACCURACY OF INFORMATION
I acknowledge that I have voluntarily applied to participate in the Inward Bound Mindfulness Education, Inc (iBme, Inc) retreat for teenagers and/or young adults entitled Teens of Color East Online Retreat, which will take place virtually. I acknowledge that all information on this application is accurate and complete - including all medical information.
2. RELEASE
As consideration for being permitted by iBme, Inc and the retreat facility to participate in these activities and use their facilities, I hereby agree that I, my parents, my guardians, my assignees, heirs, distributees, and legal representatives will not make a claim against, sue or attach the property of iBme Inc or facility, their affiliates, employees, agents or volunteers or any of their affiliated organizations for injury or damage resulting from acts, howsoever caused, by any employee, agent, or contractor of iBme Inc or facility, or any of their affiliated organizations, as a result of my participation in this event, except when an employee, agent, or contractor of iBme Inc and facility, or any of their affiliated organizations exhibits gross negligence or intentionally acts in a manner likely to lead to my being harmed. I hereby release iBme, Inc, facility and any of their affiliated organizations from all actions, claims or demands that I, my parents, my assigns, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my participation in this event, except when an employee, agent, or contractor of iBme Inc or facility or any of their affiliated organizations exhibits gross negligence or intentionally acts in a manner likely to lead to my being harmed.
3. KNOWING AND VOLUNTARY EXECUTION
I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract among myself, iBme, Inc, facility and/or their affiliated organizations, and sign it of my own free will.
4. VIDEO/AUDIO
I do hereby confirm the consent given you with respect to your photographing or recording me or my child in connection with the iBme,
Inc Teen Retreat. I hereby grant to you the right to use all the videos, photographs, and audio recordings which you may make of me or my child, and the right to use my name and/or child’s name or likeness in or in connection with publicly displaying the retreat or any other use of such video, picture, or audio recording.