Amazing Kids!' Launch My Dream! Team Waiver and Release of Liability Date: I understand that through my or my child’s participation in a Amazing Kids! “Launch My Dream!” Team, I hereby waive, release and discharge any and all claims for damage for personal injury, death, or property damage which I may have, or which hereafter may accrue to me, against Amazing Kids!, a project of Community Partners, or Community Partners, as a result of my participation on a Launch My Dream! Team. This release is intended to discharge, Amazing Kids!, a project of Community Partners, its trustees, officers, employees and volunteers and any public agencies, and Community Partners, from and against any and all liability arising out of or connected in any way with my or my child’s participation in the event. I further understand that accidents and injuries can arise out of the event which may cause personal injury; knowing the risks, nevertheless, I hereby agree to assume those risks and to release and to hold harmless all of the persons or agencies mentioned above who might otherwise be liable to me (or my heirs or assigns) for damages. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees. It is the intention of the parties hereto that the provisions of this paragraph be interpreted to impose on each party responsibility for their own negligence. I further hereby give permission for Amazing Kids! to use all photographs or videos taken of me or my child as a Launch My Dream! Team participant, during any events associated with the Launch My Dream! initiative for publicity and marketing purposes for the Amazing Kids! Launch My Dream! Initiative and Events. I acknowledge that I have read and fully understood the above Warning, Waiver and Release of Liability. I acknowledge that I am eighteen (18) years of age or older OR I am the parent or legal guardian of said participant. I acknowledge that I have will provide my own medical coverage with provider and policy number listed below. I further acknowledge that the reasons for my being requested to sign this Release have been fully explained to me and that I understand them. I am signing this Release of my own free will, and I have not been influenced or coerced by any representative or employee of the state. Guardian/Participant’s Signature (age 18+) Participant’s Name Date Guardian’s Name (if different than Participant’s) Medical Insurance Provider Policy Number