The Participant will participate in the Event during the Date(s) and at the Location(s) designated above. If the Participant
is a minor: I,______________________, am the parent or legal guardian of the Participant (“my child”).
Waiver of Liability: In consideration of my (my child’s) participation in the Muscular Dystrophy Association, Inc. (“MDA”)
Event on the Date(s) and at the Location(s) described above, I (my child), on behalf of myself, my family members, heirs,
personal representatives, and assigns (the “Releasing Parties”), do hereby release, waive, and discharge MDA, its
directors, officers, employees, volunteers, chapters, licensees, cooperating entities, agencies, representatives, heirs,
executors, administrators, successors and assigns (the “Protected Parties”) from liability arising from any and all claims, in
whole or in part, resulting from participation in the Event or from the negligence of the Protected Parties to the greatest
extent allowed by law.
Assumption of Risk: I understand the inherent risks of the Event. I have read the previous paragraph, and I know and
understand the nature of the Event. I understand the demands of the activities involved relative to my physical condition,
and I appreciate the types of injuries that may occur as a result of the Event and their potential impact on my well-being
and lifestyle. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.
Public Health - COVID-19: I agree to comply with any and all health and safety protocols implemented by MDA or the
Event venue appropriate to public health circumstances, including with respect to COVID-19, existing at the time of the
Event. Those protocols may include vaccination, proof of COVID status, self-monitoring, use of personal protective
equipment, social distancing, or other measures.
Indemnification: I agree to hold harmless, defend and indemnify the Protected Parties from any and all claims of the
Releasing Parties arising from injury or loss due to my (my child’s) participation in the Event, including those arising from
the inherent risks of the Event or the negligence of the Protected Parties to the greatest extent allowed by law.
Grant of Permission and Release and Waiver of Rights: I understand that MDA may photograph or make audio, video or
audiovisual recordings of the Event. In consideration of my (my child’s) participation in the Event, I hereby give MDA, its
assigns, licensees, and legal representatives the irrevocable right to videotape, film, photograph, record or otherwise
capture my (my child’s) likeness and voice (the “Participant Likeness”) and to use, broadcast, transmit, duplicate,
transcribe and/or rerecord any and/or all of the foregoing in all forms and media (including, without limitation, in digital
form or in or through any other form or means now known or hereinafter developed) for any and all purposes, in
perpetuity, throughout the world, and to use my (my child’s) name and biographical information in connection therewith.
Use of the Participant’s Likeness may include, but not be limited to, photographs, sound and video recordings, films,
broadcasts, brochures, publications, reports, web pages, social media posts, promotional materials or any other audiovisual, electronic, printed or tangible work in any media or format (the “Materials”). I acknowledge that I (my child) shall
not have any ownership in or use of the Materials or any right of review or approval regarding the use of the Participant’s
Likeness in the Materials and I waive any right to inspect or approve the finished version(s) of the Materials, including
written copy that may be created in connection therewith.
Except for the consideration recited above, I understand that I (my child) will not be compensated in connection with the
Materials, but that MDA will be relying on this Grant of Permission and Release and Waiver of Rights (the “Release”) in
determining to use the Materials. Accordingly, the Releasing Parties hereby release and hold harmless the Protected
Parties from any and all claims, demands, or causes of action arising out of the creation or use of the Participant’s
Likeness and Materials.
Personal Data: I understand and agree that my personal data may be collected as a result of my registration and
participation in the Event and will be used in accordance with MDA’s Privacy Policy.
Acknowledgment of Understanding; Severability; Jurisdiction: I have read this Waiver, Indemnification and Grant of
Permission Agreement and fully understand its terms. I further acknowledge that I am signing this Agreement freely and
voluntarily and intend my signature to be a complete and unconditional release of all liability. If any portion of this Agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
This Agreement shall be governed by the laws of the State of New York.
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