Team Gleason Liability and Photo

Release Form
Liability Release (Required for Team Gleason): The undersigned voluntarily agrees to participate in the
Adventure/Gift program sponsored by the Team Gleason Initiative Foundation.
The undersigned recognizes that Team Gleason has not undertaken any duty or responsibility for his or her
safety and the undersigned agrees to assume full responsibility for all risk of bodily injury, death, disability, and
loss or property damage as a result of participating in the Team Gleason Adventure/Gift Program.
By signing my name, I hereby state that I knowingly and freely accept any and all risks; even if arising from the
negligence of the releasees or others; encountered while participating in the Team Gleason Adventure/Gift
Program. By my signature, I hereby surrender any right to seek reimbursement from Team Gleason and its
owners, directors, board members, employees, volunteers, assignees, delegatees, and other agents for injury
sustained and liability incurred during my participation in the adventure.
Conditions: This Agreement contains the entire agreement of the parties with respect to the subject matter of
this Agreement, and supersedes all prior negotiations, agreements and understandings with respect thereto. This
Agreement may only be amended by a written document duly executed by all parties.
I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State
of Louisiana, and that this Release shall be governed by and interpreted in accordance with the laws of the State
of Louisiana.
By signing this document, I certify that I have read and fully understand the contents of this document. I also
agree that I am not relying on any statements or representations of any Released Party. This document shall be
binding upon me, my heirs, executors, and administrators.
______________________________________________________
________________________
Signature

Date

______________________________________________________
________________________
Print Name

Date

If the person signing is under age 21, there must be consent by a parent or guardian, as follows:
I hereby certify that I am the parent or guardian of _______________________, named above, and do give my
consent to the foregoing on behalf of this person.

__________________________________________
(Parent/Guardians Signature)
__________________________________________
(Parent/Guardians Printed Name)

______________________
(Date)

Photographic Release (Required) I grant The Team Gleason Initiative Foundation, its representatives, and
employees the right to take photographs of me and my property in connection with the Team Gleason
Adventure/Gift Program. If a Team Gleason Representative is not present and I submit pictures or video footage
I give Team Gleason full permission to use, edit, and publish content. I agree The Team Gleason Initiative
Foundation may use photographs of me with or without my name and for a lawful purpose, including, but not
limited to such purposes as publicity, illustration, and Web Content.
By signing this document, I certify that I have read and fully understand the contents of this document. I also
agree that I am not relying on any statements or representations of any Released Party. This document shall be
binding upon me, my heirs, executors, and administrators.
__________________________________________
(Signature)

_______________________
(Date)

__________________________________________
Print Name
If the person signing is under age 21, there must be consent by a parent or guardian, as follows:
I hereby certify that I am the parent or guardian of _______________________, named above, and do give my
consent to the foregoing on behalf of this person.

__________________________________________
(Parent/Guardians Signature)
__________________________________________
(Parent/Guardians Printed Name)

______________________
(Date)