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*Event Disclaimer* PLEASE READ CAREFULLY. ALL PARTICIPANTS MUST BE 21 OR OLDER. ALL SALES ARE FINAL. YOUR REGISTRATION IS NOT COMPLETE UNTIL THIS FORM IS READ AND SUBMITTED AT CHECK-IN WITH PAYMENT. FAILURE TO COMPLETE THIS FORM WILL RESULT IN REFUSAL TO ALLOW PARTICIPATION IN THE BRICKELL TRICK-OR-TREAT CRAWL. DISCLAIMER CLAUSE: Miami AmeriCorps Alums members, directors, officers, representatives and/or volunteers are not responsible for any injury, loss or damage of any kind sustained by any person while participating in the Brickell Trick-or-Treat Crawl, including injury, loss or damage which might be caused by the negligence of Miami AmeriCorps Alums. PHOTOGRAPHY RELEASE: I, as the subject of photographs/video taken on this date, hereby consent and authorize the use and production of the photographs/videos by Miami AmeriCorps Alums. These same photographs/video may be used for any purpose including, but not limited to, promotion, advertising and public relations without further compensation or consent. ASSUMPTION OF RISKS: In consideration of my participation in the Brickell Trick-or-Treat Crawl, I acknowledge that I am aware of the possible risks, dangers and hazards associated with my participation in the Brickell Trick-or-Treat Crawl, (including the possible risk of severe or fatal injury to myself or others). These risks include but are not limited to the following: a) The risks associated with travel to and from location(s) to be visited during the Brickell Trick-or-Treat Crawl, including transportation provided by commercial, private and/or public motor vehicles; b) Intoxication and/or alcohol poisoning from the alcohol I consume whether voluntarily or through coercion; c) The possibility of bodily injury (broken bones and soft tissue damage) including dental damages from falling down, injuries incurred while getting on or off (in or out of) the mode of transportation being used for the event, being knocked down or being involved in a physical confrontation whether caused by myself or someone else; d) The risks associated with returning to my residence. INDEMNIFICATION AND RELEASE OF LIABILITY: In return for Miami AmeriCorps Alums allowing me to voluntarily participate in the Brickell Trick-or-Treat Crawl and related activities, I agree: 1. TO ASSUME AND ACCEPT ALL RISKS arising out of, associated with or related to my participating in the Brickell Trick-or-Treat Crawl; 2. TO BE SOLELY RESPONSIBLE FOR ANY INJURY, LOSS OR DAMAGE which I might sustain while participating in the Brickell Trick-or-Treat Crawl; 3. TO HOLD HARMLESS AND INDEMNIFY MIAMI AMERICORPS ALUMS a) From any and all liability for any damage to the personal property of, or personal injury to, any third party resulting from my participation in the Brickell Trick-or-Treat Crawl and all related activities; including., but not limited to any and all activities caused by the negligence of myself or any third party; and b) From any and all claims, demands, actions and costs which might arise out of my participation in the Brickell Trick-or-Treat Crawl. PROTECTION OF PRIVACY - The personal information requested on this form will only be used for the purpose of implementing this waiver and will not be shared with any other entity. ACKNOWLEDGEMENT: I acknowledge that I have read this agreement, that I have executed this agreement voluntarily, and that this agreement is to be binding upon myself, my heirs, executors, administrators and representatives, in the event of my death or incapacity.

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