PROGRAM (“Event"): _______________________________________________________ 

 

LOCATION ________________________________________________________________ 

 

TO BE HELD ON OR ABOUT: ____________________, 2023  

 

PARTICIPANT’S NAME AND AGE (“Participant”):_______________________________ 

 

In consideration for being permitted to participate in the above-referenced Event (the “Event”), I agree to the following:  

 

1. In connection with the Event and my participation therein, I assume full risk and responsibility for any death, disability, illness (including without limitation, COVID-19, any variation thereof, and any other pathogen) or bodily injury that I may suffer or contract, or damage to property that may be caused, arising from any cause whatsoever, or any death, disability, illness, or bodily injury or property damage to another person arising from my participation in the Event. I have considered all the risks involved, and I voluntarily choose to assume all such risks, both known and unknown, even those risks that result from the negligence of the Released Parties or others and assume full responsibility for my participation in the Event.

 

2. I forever discharge and release Eurostar, Inc. d/b/a WSS, a Delaware corporation, having its principal office at 879 W 190th Street, Gardena, CA 90248, and all of its direct or indirect owners, officers, directors, shareholders, employees, agents, affiliated entities, agencies, representatives, contractors, successors, assigns, subsidiaries, partners, board members, commissioners, directors, officers, contractors, consultants, sponsors, subcontractors, independent contractors, and insurers (collectively the “Released Parties”) from any and all claims, losses, or damages directly or indirectly arising from any such death, disability, illness (including without limitation, COVID-19, any variation thereof, and any other pathogen, collectively “COVID-19”), or bodily injury or property damage, and any claim or legal action of any nature, known, or unknown, in law or inequity, which I or my heirs, legal representatives, executors, administrators, or any other person may make while acting on my behalf or on behalf of my estate in that regard.

 

3. Subject to and without limitation to the foregoing, I expressly acknowledge an inherent risk of exposure to COVID-19 exists in any place where people gather, including at the Event, and that no precautions can eliminate the risk of exposure to COVID-19. COVID-19 is an extremely contagious disease that can lead to severe illness and death. While people of all ages and health conditions have been adversely affected by COVID-19, certain categories of people have been identified by public health authorities as having greater risk based on age and underlying medical conditions. I understand and acknowledge that such exposure or infection may result in serious illness, personal injury, permanent disability, death, or property damage. I acknowledge that this risk may result from or be compounded by the actions, omissions, or negligence of others, including the Released Parties. I understand that while the Released Parties may have implemented preventative measures to reduce the spread of COVID-19, the Released Parties cannot guarantee that I will not become infected with COVID-19 while at the Event and that it may increase my risk of contracting COVID-19. I ACKNOWLEDGE THAT I AM VOLUNTARILY ENTERING THE PREMISES TO ENGAGE IN THE EVENT WITH KNOWLEDGE OF THE DANGER INVOLVED. I HEREBY AGREE TO ACCEPT AND ASSUME ALL RISKS OF PERSONAL INJURY, ILLNESS, DISABILITY, DEATH, OR PROPERTY DAMAGE RELATED TO COVID-19, ARISING FROM MY BEING ON THE PREMISES OR ENGAGING IN THE EVENT, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE. I am familiar with federal, state, and local laws, orders, directives, and guidelines related to COVID-19, including the Centers for Disease Control and Prevention (CDC) guidance on COVID-19. I acknowledge that the CDC and many public health authorities still recommend practicing social distancing, hand sanitation, and use of face coverings. I agree to follow all instructions of the Released Parties while on the Premises to participate in the Event. I agree not to enter the Premises if I am experiencing symptoms of COVID-19, such as cough, shortness of breath, fever, difficulty breathing, chills, fatigue, muscle or body aches, headache, sore throat, congestion or runny nose, nausea or vomiting, diarrhea, new loss of taste or smell, have a confirmed or suspected case of COVID-19, or have come in contact in the last 14 days with a person who has been confirmed or suspected of having COVID-19.

 

4. I VOLUNTARILY ASSUME ALL RISK AND DANGER of personal injury (including death), sickness (including illness and other risks of exposure of COVID-19 or any other communicable disease or illness, or a bacteria virus or other pathogen capable of causing a communicable disease or illness), lost, stolen, damaged or confiscated property, and all other hazards arising from, or related in any way to, the Event, whether occurring prior to, during, or after the Event, however caused and whether by negligence or otherwise. I further hereby release (and covenant not to sue) each of the Released Parties with respect to any and all claims that I may have (or hereafter accrue) against any of the Released Parties and that relate in any way to (i) exposure to COVID-19; (ii) entry into, or presence within or around, the Event (including all risk related thereto); (iii) compliance with any protocols or safety requirements applicable to the Event; (iv) my participation in the Event; or (v) any interaction between me and any person or any personnel of any of the Released Parties present at the Event, in each case whether caused by any action, inaction, or negligence of any Released Parties or otherwise, to the fullest extent permitted by law. 

 

5. Participant acknowledges that the RELEASED PARTIES MAKE NO WARRANTY, EXPRESS OR IMPLIED, REGARDING THE EVENT and agrees that the Released Parties will not, under any circumstance, be liable for consequential, indirect, special or similar damages. I shall defend, indemnify, and hold harmless the Released Parties against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, arising out of or resulting from, in whole or in part, my participation in the Event, including without limitation while preparing for, participating in and/or traveling to or from the Event, and any claim of a third party related to COVID-19 due to my engaging in the Event, whether arising from negligence of the Released Parties or otherwise, to the fullest extent permitted by law.

 

6. I hereby grant to Eurostar, Inc. d/b/a WSS and all of its direct or indirect owners, officers, directors, shareholders, employees, agents, affiliated entities, agencies, representatives, contractors, successors, assigns, subsidiaries, partners, board members, commissioners, directors, officers, contractors, consultants, sponsors, subcontractors, independent contractors, and insurers, the worldwide right in perpetuity to use my name, my voice, and/or my picture in any broadcast, telecast, advertising, promotion, or other account of the Event in any form and for any legitimate purpose, without compensation or approval, and without obligation to use. I further grant and authorize to Eurostar, Inc. d/b/a WSS and the Released Parties, the absolute right and permission to edit, alter, copy, copyright, use, reproduce, exhibit, publish, distribute and make use of any and all photographs, videos, photographic portraits or pictures, videotapes, motion pictures, sketches, recordings or any other graphic or digital  reproductions of me, to be used in and/or for any and all promotional materials, including but not limited to, newsletters, flyers, posters, brochures, advertisements, campaigns, fundraisers, fundraising letters, annual reports, press kits and submissions to journalists, websites, social media/networking sites, any and all print and digital communications, and for any other lawful purpose whatsoever, without payment or any other consideration. This authorization extends to all languages, media, formats, and markets, now known or hereafter devised. This authorization shall continue worldwide and in perpetuity.

 

7. I release and transfer forever without reservation and without compensation or consideration: (i) all rights in and to my participation in the event and the reproduction or other transcriptions of the event by video, film, or any other methods, and (ii) the use of my name, picture, portrait, likeness or identification in all media and modes of advertising or promotion of or by the Released Parties and their respective designees, for or in connection with the Event, Eurostar, Inc. d/b/a WSS, and for any other purpose. 

 

8. I agree to be contacted by and receive marketing and other communications from the Released Parties and their respective designees via the contact information provided below (including, without limitation, via the email address provided). I agree that my personal information may be used and shared by Released Parties for purposes including advertising, promotion, analytics and as otherwise provided in our Privacy Statement, as may be updated from time to time. 

 

9. This Participant Release constitutes the sole and entire agreement of the Released Parties and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. I agree that this Consent and Release is intended to be as broad and inclusive as is permitted by the laws of the State of New York, and further agree that if any portion hereof is held invalid, the balance shall nevertheless continue in full legal force and effect. This Participant Release is binding on and shall inure to the benefit of the Released Parties and me and our respective successors and assigns.

 

10. In the event of a dispute between the Released Parties and myself, such dispute shall be governed by, construed, and enforced in accordance with the laws of the State of New York, without regard to its conflict of laws principles.

 

□ Participant or Participant’s parent or legal guardian (if a minor) warrants that all statements made herein are true and correct and understand that Released Parties have relied on them in allowing Participant to participate in the Event. PARTICIPANT or PARTICIPANT’S PARENT/LEGAL GUARDIAN (if a minor) HAS READ THE FOREGOING AND INTENTIONALLY AND VOLUNTARILY SIGNS AUTHORIZATION, AND UNDERSTANDS THAT PARTICIPANT IS ASSUMING THE RISK OF, AND RELEASING AND HOLDING HARMLESS THE RELEASED PARTIES IN CONNECTION WITH PARTICIPANT’S PARTICIPATION IN THE EVENT. 

 

□ Participant or Participant’s parent or legal guardian (if a minor) affirms that they have read each and every paragraph of this Consent and Release prior to its execution, fully understands and agrees to its terms, and agrees to indemnify the Released Parties from and against any liability arising out of any claim of any invalidity of this affirmation. 

 

I CERTIFY THAT: 

 

□ Participant is over the age of minority (18 years of age or older in most states), or  

 

□ Participant has their parent or legal guardian’s consent as indicated below.  

__________________________________________________________________________ 

PARTICIPANT SIGNATURE                          DATE SIGNED 

________________________________________________________________________ 

PRINT NAME                                       

 __________________________________________________________________________ 

ADDRESS 

__________________________________________________________________________ 

EMAIL ADDRESS  

_______________________________________________________________________ 

SOCIAL MEDIA  

 

IF PARTICIPANT IS A MINOR, PARTICIPANT’S PARENT OR LEGAL GUARDIAN MUST READ, SIGN AND CHECK BOX BELOW: 

 

□ I affirm that I am the parent or guardian of the participant described above (“Participant”); I have the authority to give this authorization and the release described above on behalf of the child; I have read and I understand this authorization and the release described above and voluntarily consent to the terms set forth; I also, for myself and on behalf of my heirs, estate, insurers, successors and assigns, hereby release and discharge the Released Parties (defined above) from any and all claims or causes of action I may have for damages for personal or bodily injury (whether to myself or my child), illness, disability, death, loss or damage to person or property, whether arising from the negligence of any or all of the Released Parties or otherwise, to the fullest extent permitted by law; I further certify that the Participant is in good physical condition and is able to safely participate in the Event;  and I agree to defend and indemnify the Released Parties from and against any liability arising out of any claim of any invalidity of this affirmation.  

 

__________________________________________________________________________ 

PARENT/LEGAL GUARDIAN SIGNATURE                          DATE SIGNED 

__________________________________________________________________________ 

PARENT/LEGAL GUARDIAN’S NAME                                                                                  

__________________________________________________________________________ 

ADDRESS 

_________________________________________________________________________ 

EMAIL ADDRESS  

 

IF PARTICIPANT IS AN AMATEUR ATHLETE, PARTICIPANT’S PARENT OR LEGAL GUARDIAN MUST READ AND CHECK BOX BELOW: 

 

□ To the extent applicable, I have verified with my school, athletic director, and/or the governing body of my sport(s) that participation in the Event does not violate any rules including, but not limited to, rules of eligibility for sport participation at my school and rules affecting my amateur status in any sport. 

 

♦ By signing above and checking the box below, I acknowledge and agree that (i) I have read, voluntarily consent to, and understand the provisions set forth in this Eurostar, Inc. d/b/a WSS Consent and Release (“Release”), and (ii) I have executed this Release by signing above and checking the box below. If I am submitting this Release on behalf of a participant less than 18 years of age during the time of the Event, I affirm that I am the parent or legal guardian of such participant, that I have the authority to execute this Release on behalf of such participant, and that I agree to indemnify the Released Parties from and against any liability arising out of any claim of any invalidity of this affirmation.  

 

□ I acknowledge.