Common use of Use of Image Clause in Contracts

Use of Image. I hereby consent to the use of my image by EMPOWER for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(S) Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Street Address: City: State: Zip: Phone Number: Email Address: Emergency Contact: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: (Over 18 years of age) Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (Xxxxx’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWER. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date:

Use of Image. I hereby consent to the use of my image by EMPOWER for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(S) Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Street Address: City: State: Zip: Phone Number: Email Address: Emergency Contact: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: (Over 18 years of age) Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (XxxxxMinor’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWER. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date:

Use of Image. I hereby consent to the use of my image by EMPOWER for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. Initial PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(S) Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Street Address: City: City State: Zip: Phone Number: Email Address: Emergency ContactContact Name & Relationship: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. By providing my email address, I opt in and I understand that my email information will be entered into the Empower Adventures marketing database. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: Participant Signature (Over if 18 years of age) or older): Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (Xxxxx’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWER. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date:

Use of Image. I hereby consent to the use of my image by EMPOWER for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(SPARTICIPANTS) Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Street Address: City: City State: Zip: Phone Number: Email Address: Emergency ContactContact Name & Relationship: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: Participant Signature (Over if 18 years of age) or older): Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (Xxxxx’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWER. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date:

Use of Image. I hereby consent to the use of my image by EMPOWER Empower for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(S) Initial Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Weight (Must weight 50 to 275lbs) Street Address: City: State: Zip: Phone Number: Email Address: Emergency Contact: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. By providing my email address, I opt in and I understand that my email information will be entered into the Empower Adventures marketing database. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: (Over 18 years of age) Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (XxxxxMinor’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWEREmpower. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date:

Use of Image. I hereby consent to the use of my image by EMPOWER for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(SPARTICIPANTS) Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Street Address: City: City State: Zip: Phone Number: Email Address: Emergency ContactContact Name & Relationship: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: Participant Signature (Over if 18 years of age) or older): Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (XxxxxMinor’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWER. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date:

Use of Image. I hereby consent The RELEASING PARTY consents to the use of my his or her image in photographs, videos, slides and movies taken at the Facility by EMPOWER for any and all purposesstudents, includingstaff, TV, Radio and/or other news or other media, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement remuneration of any product kind. I understand that all pictures and digital images become property of Xxxx Xxxxxxx, LLC d/b/a Xxxx Xxxxxxx Training Center, or serviceits assigns, and might appear in promotional materials, advertising, publications and social media. PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(S) Name Signature of Participant: (Print Clearly) Initial Releasing Party Date Date of Birth: _ Weight: Check In on Facebook Street Address: City: State: Zip: Phone Number: Email Address: Emergency Contact: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, Print Name APPROVAL OF PARENT/LEGAL GUARDIAN ON BEHALF OF MINOR I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: (Over 18 years of age) Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), am the parent/legal guardian of (Xxxxx’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWERbelow-named minor. I have reviewed read and understand the agreement and realize the agreement involves releasing valuable legal rights of the minor and myself. I agree to be bound by all of the terms of the above Agreement and, as parent/guardian, accept its termsagreement. I have discussed the terms of the above Agreement with also give my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, consent to the fullest extent allowed by law, to release participation in the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation Activity by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENTalso give my consent for the minor to be included in photographs, videos, slides and movies taken at the Facility by students, staff, TV, Radio and/or other news or other media without remuneration of any kind. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMSunderstand that pictures become property of Xxxx Xxxxxxx, LLC d/b/a Xxxx Xxxxxxx Training Center, or its assigns, and might appear in promotional materials and publications. Print Name of Minor Minor’s Date of Birth Today’s Date Print Name of Parent/Guardian’s Signature: Date:Legal Guardian of Signature of Parent/Legal Guardian Minor Under the Age of 18 PARENT/LEGAL GUARDIAN EMERGENCY TREATMENT CONSENT As the parent and/or legal guardian of the above-named minor, I agree that the minor may participate in the Activities. I designate any representative of the Xxxx Xxxxxxx Training Center to make any emergency medical decisions for the minor in the event of accident, injury or illness.

Use of Image. I hereby consent to the use of my image by EMPOWER for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. Initial PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(S) Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Street Address: City: City State: Zip: Phone Number: Email Address: Emergency ContactContact Name & Relationship: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. By providing my email address, I opt in and I understand that my email information will be entered into the Empower Adventures marketing database. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: Participant Signature (Over if 18 years of age) or older): Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (XxxxxMinor’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWER. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date:

Use of Image. I hereby consent to the use of my image by EMPOWER Empower for any and all purposes, including, without limitation or compensation: Video, still photographs, publication and any trade or advertising purposes, providing such uses are not made as to constitute a direct endorsement of any product or service. PARTICIPANT INFORMATION (MUST BE COMPLETED FOR ALL PARTICIPANT(S) Name of Participant: (Print Clearly) Initial Date of Birth: _ Weight: Check In on Facebook Street Address: City: State: Zip: Phone Number: Email Address: Emergency Contact: Phone Number: Emergency Contact’s Relationship to Participant: By signing this document, I acknowledge that I may be found by a court of law to have waived my right to a lawsuit against the Released Parties on the basis of any claim herein from which I have released them. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE CAREFULLY READ AND UNDERSTOOD IT AND AGREE TO BE BOUND BY ITS TERMS. Participant’s Signature: (Over 18 years of age) Date: PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (MUST BE COMPLETED FOR PARTICIPANTS UNDER THE AGE OF 18) I, (parent/guardian name), the parent/guardian of (Xxxxx’s name) whose date of birth is / / give permission for my child to participate in the activities and utilize the equipment and facilities provided by EMPOWEREmpower. I have reviewed the terms of the above Agreement and, as parent/guardian, accept its terms. I have discussed the terms of the above Agreement with my child and am assured by my child that he/she understands the Agreement and has also freely accepted its terms. I agree to fully release, indemnify and hold harmless the Released Parties from any claims which I may have and, to the fullest extent allowed by law, to release the Released Parties on behalf of my child for any claim(s) that my child may have. I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of the above stated minor and which are in any way connected with such use or participation by the above stated minor. I HAVE HAD THE SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT AND AGREE THAT MYSELF AND MY MINOR CHILD ARE TO BE BOUND BY ITS TERMS. Parent/Guardian’s Signature: Date: