AS THE FUN AND GAMES GROW ...
... so does our responsibility for each of you! As time passes, Hooked on Smiles is able to offer more activities and special events for the enjoyment of our participants and guests. Unfortunately, as we grow we have more rules to follow... just like each of you as you grow up. In order to keep everyone out of trouble, Hooked on Smiles must obtain a signed release form for everyone participating and sharing in the fun and games. All events and activities require that we have a signed release in our file for anyone attending. If you would like to join in the fun and participate in our very special programs, please print the form below and send it to HOOKED ON SMILES, INC., 1848 Big Crane Loop, Port Orange, FL 32128. (Note: To print the form properly, please use the "landscape" function on the PRINT command page)
Thank you for your help and we'll see you soon!
RELEASE
In consideration of being permitted to participate in Hooked on Smiles ("Smiles") events and activities, I hereby forever release, waive and discharge Hooked on Smiles, Inc., directors, officers, employees, agents, sponsors and volunteers from any and all liability, including without limitation all losses, damages, claims, or demands on account of injury or death whether caused by any negligence (gross or otherwise) or intentional misconduct of the releasees or otherwise, during or in connection with my participation in Smiles activities. During these activities, various images of me--including photographs, film video tape, sound recording, and/or other likenesses (collectively, the "Images") may be created. I hereby consent to the creation, ownership and use of those Images by Smiles and its affiliates. Pursuant to this Release, I shall refrain from making any claim or demand, or commencing, causing, or permitting to be prosecuted, any action in law or suit in equity against the releasees, on account of any personal injuries, disability, property damage and loss of services, as well as any costs, damages, or expenses incurred or suffered that I might sustain in connection with participation in such activities. Further, I hereby release and discharge any and all claims I have or may have in connection with any use of the Images as described above by Smiles. I know of no reason why I should not participate in said actvities.
I have read this Release and am fully aware of its contents. This Release and the obligations and undertakings herein shall be binding on me and my legal representatives, heirs, next of kin, successors, and assigns.
Date: ____________________
Name: ____________________________ [print name]
Name: ____________________________ [signature]
If the above identified person is a minor under age 18, unable to sign, or has an appointed legal guardian or representative, the following consent must be signed by that guardian or representative:
I hereby certify that I am the legal guardian or representative of ________________________________ _________________ named above (the "Participant"), and, on behalf of myself and the Participant, I have the necessary legal authority to execute this Release and to grant the rights stated above, and that I do hereby grant such rights on behalf of myself and the Participant. I have read this Release and am fully aware of its contents. This Release shall be binding on me, the Participant, and our respective legal representatives, heirs, next of kin, successors, and assigns.
Date: ______________________
Name: ______________________________ [print name]
Name: ______________________________ [signature]
Note: If you are the legal guardian and/or representative of more than one participant, you may include all names on one (1) release form.
