OAA QUARTERMANIA: OBESITY AWARENESS IN ACTION PERMISSION TO PARTICIPATE, RELEASE AND WAIVER, INDEMNIFICATION CONSENT TO MEDICAL TREATMENT AND PHOTO RELEASE

In consideration of me or my minor child being permitted to participate in any way in the above named Activity, I, the Undersigned, for me and my minor child, all of my or my minor child’s personal representatives, executors, administrators, heirs, next of kin, successors and assigns, herein referred to as “Releasers”, do hereby:

1. Acknowledge that this Activity may be a major test of a person’s physical and mental limits and carries with it the potential for serious injury, death and/or property damage, and certify as to the physical fitness of me and that of my minor child to participate and declare that me and my minor child have not been advised otherwise by a qualified medical professional.

2. Acknowledge, agree, and represent that I and my minor child will, at all times, be aware of the surroundings during the Activity and agree that if I or my minor child considers anything related to this Activity to be unsafe, will immediately advise the Activity officials of such, and if necessary, will leave the area or refuse to participate further in the Activity.

3. Waive, release and discharge, and covenant not to sue, Obesity Awareness IN Action its elected and appointed officials, officers, employees, volunteers, sponsors, and agents, including others who give recommendations, directions, or instructions as part of this Activity, hereinafter referred to collectively as “OAA” throughout this agreement, from any and all liability to Releasers, except for my minor child, any and all loss or damage, and any claim or demands therefore, on account of injury to the person or property or resulting in my death or that of my minor child arising out of or related to the Activity.

4. Agree to Indemnify and Save and Hold Harmless OAA and each of member from any loss, liability, damage, or cost that OAA or third parties may incur arising out of or related to me or my minor child’s participation in this Activity.

5. Assume full responsibility for any risk of bodily injury, death or property damage arising out of or related to the Activity.

6. Agree that this Release and Waiver and Indemnification Agreement extends to all acts of negligence by OAA, not including gross negligence and willful misconduct, and is intended to be as broad and inclusive as is permitted by law including any governmental immunity afforded OAA by law and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

7. Authorize any medical treatment, including the administration of anesthesia, deemed advisable by any licensed physician to relieve any injuries received or illness contracted by me or my minor child as a participant in this Activity. I hereby agree to pay all costs of any medical treatment or emergency transportation.

8. Authorize and consent to OAA, and any news media, and their successors and assigns and those acting under their authority, to take, publish, use in any media, and copyright photographs, videotape or other and audio or visual media, including broadcast in any media, of me and my child and agree that such may be used for any lawful purpose without further compensation or approval. I have read this Permission to Participate, Release and Waiver, Indemnification, Consent to Medical Treatment and Photo Release, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it voluntarily without assurance or guarantee being made to me, and intend my signature to be a complete and unconditional release of all liability to the fullest extent permitted by law, including all acts of negligence by OAA as stated above.