Welcome to PAN DE VIDA FOUNDATION Back to School Back Pack Program. Please fill out a registration waiver form below with your information. Thank You.
Bienvenidos al Programa de Mochilas de la FUNDACIÓN PAN DE VIDA. Complete un formulario de exención de registro a continuación con su información. Gracias.
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PAN DE VIDA WAIVER OF LIABILITY FOR ALL EVENTS/ACTIVITIES.
IN CONSIDERATIONS OF the risk of injury that exist while participating in CHILDREN’S DAY / DAY DEL NINO (HEREINAFTER THE “ACTIVITY” AND/OR “EVENT”); and
IN CONSIDERATION OF my desire to participate in said activity and being given the right tort participate in same;
I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, “ Releasor,” “I” or “me”, which terms shall also include Releasor’s parents or guardians if releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and nearby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity and/or event and
I HEREBY release and forever discharge PAN DE VIDA FOUNDATION A 501(C)(3), event location at 34488 CARRIAGE DR, SAN TAN VALLEY, Arizona 85140, or other sites for which Pan De Vida Foundation may hold an event or with in collaboration with others, or partake in others events at other locations outside of Pan De Vida Events and their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, or psychological injury that I may suffer as a direct result of my participation in the aforementioned “Activity” and/or “Event” for which is held for the children.
I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISK ASSOCIATED WITH THE PARTICIPATING IN THIS ACTIVITY AND/OR EVENT ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISK ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING,ILLNESS, DISFIGUREMENT, TEMPORARY PR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY AND/OR EVENT.
I FURTHER AGREE to indemnify, defend and how harmless and the Release against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related cost.
I FURTHER ACKNOWLEDGE that Releases are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of releasees. In the event that I should require medical care or treatment, I authorized PAN DE VIDA FOUNDATION 501(C)(3) to provide all emergency medical care deemed necessary, including but not limited, first aid, CPR, the use of AED’s, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assumer all cost involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.
I FURTHER ACKNOWLEDGE that this Activity/Event may involve a test of personal physical and mental limits and may carry with it the potential for death, serious injury, property loss. I agree not to participate in the Activity unless I am medically able and properly trained, and I agree to abide by the decision of the PAN DE VIDA FOUNDATION 501(c)(3) official or agent, regarding my approval to participate in the Activity.
I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE.” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE PAN DE VIDA FOUNDATION 501(C)(3) FOR PERSONAL INJURY OR PROPERTY DAMAGE.
To the extent that statue or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of PAN DE VIDA FOUNDATION 501(C)(3), ITS AGENTS, AND EMPLOYEES.
I agree that this Release shall be governed for all purposes by Arizona law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or other agreements.
In the event that any damage to equipment or facilities occurs as a result of my or my family’s or my agents willfully actions, neglect or recklessness, I acknowledge and agree to by help liable for any and all cost associated with any such actions of neglect or recklessness.
THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY AND/OR EVENT, DURING THIS INITIAL AND ALLL SUBSEQUENT EVENTS OF PARTICIPATION.
THIS AGREEMENT was entered into at arm’s-length, without duress of coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both participant, The “participant and those which they claim liability for in the terms and agreements of this event and the activity(s) participants may take action to participate willingly. PAN DE VIDA FOUNDATION 501(C)(3) agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter to explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.
In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, conditions, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that any provisions of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as s limited.
In the event of an emergency, please contact emergency services.
I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY AGREEING TO THIS AGREEMENT THROUGH OPTING-IN AND FILLING OUT THIS FORM TO GAIN ACCESS TO SUCH EVENT AND ACTIVITIES. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT THAT I AM AGREEING TO WITH THE CHECKBOX OPT-IN OPTION TO ATTEND SUCH EVENT AND/OR PARTAKE IN THE ACTIVITY(S). I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT I AND AGREEING TO IT OF MY OWN FREE WILL.
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