Day of Action Waiver

I hereby assign the rights to the video and/or photographic recording(s) made of me by Sioux Empire United Way or its agency(s), hereafter referred to as United Way, to said United Way. I hereby authorize the editing, duplication, reproduction, copyright, exhibition, broadcast, and/or nonprofit use and distribution of said recording(s) for purposes deemed suitable by United Way.

I hereby waive any right to approve the finished products. I hereby certify that I am over eighteen years of age and am competent to contract my own name insofar as the above is concerned.

I have read the foregoing release, authorization, and agreement, before affixing my signature below and warrant that I fully understand the contents thereof.

I hereby release, indemnify and hold harmless Sioux Empire United Way, the organizers, the agency at which I volunteer and the sponsors and supervisors of all activities, from any and all liability in connection with any injury (including any injury caused by negligence) in conjunction with Day of Action.  I likewise hold harmless from liability any person transporting me to or from any United Way activity.

I also certify that I am in good health and able to participate in the program activities during the Day of Action. I certify that I am over eighteen years of age and am competent to contract my name insofar as the above is concerned. I have read the foregoing release, authorization, and agreement, before affixing my signature below and warrant that I fully understand the contents thereof.