Skip survey header

Tai Chi 2022 Waiver

This Photo Release and the Waiver of Liability (“Release and Waiver of Liability”) must be signed by all participants who take part in the (“Program”) sponsored by the American Nurses Association, its subsidiaries and affiliates, with offices at 8515 Georgia Ave, Suite 400, Silver Spring, MD 20910 (hereinafter collectively referred to as "ANA Enterprise").  The Program is scheduled to take place at the 2022 ANCC Pathway to Excellence® and ANCC National Magnet Conference® on October 13, 2022.  This Agreement shall be effective from the date of signature, listed below.

WAIVER OF LIABILITY

PLEASE READ THIS AGREEMENT CAREFULLY.  IT IS A LEGAL CONTRACT AND AFFECTS ANY RIGHTS YOU MAY HAVE IF YOU ARE INJURED OR OTHERWISE SUFFER DAMAGES WHILE PARTICPATING IN THE PROGRAM SPONSORED BY ANA ENTERPRISE.

Inherent Risk and Dangers of the Program: The Program will offer participants the opportunity to participate in various physical activities (“Physical Activities”), including but not limited the activities the participant will perform and demonstrations, which involve a number of inherent risks including, but not limited to health risks. I, the undersigned, hereby certify that I (1) am medically and physically fit, (2) will be financially responsible for any medical treatment arising from my participation, and (3) am participating voluntarily.

ASSUMPTION OF RISK, RELASE AND WAIVER OF LIABILTY

I, the undersigned, HEREBY RELEASE FROM LIABILITY, WAIVE, DISCHARGE AND COVENANT NOT TO TAKE LEGAL ACTION against the ANA Enterprise, its subsidiaries and affiliates, and any of their officers, directors, servants, agents, and employees (hereinafter collectively referred to as RELEASEES) for any liability, claim and/or cause of action arising out of or related to any loss, damage or injury, including death, that occurs as a result of my participation in the Program or Physical Activities. I agree to indemnify and hold harmless the RELEASEES whether injury is caused by my negligence, the negligence of the RELEASEES or the negligence of any third party.  I further agree that this Release and Waiver of Liability shall bind all parties affiliated with me, my agents, heirs, successors and assigns and constitute a COVENANT NOT TO TAKE LEGAL ACTION against the above-named RELEASEES. I hereby further agree that this Release and Waiver of Liability shall be construed in accordance with the laws of the State of Maryland.

MEDICAL EMERGENCY PERMISSION
If an injury or other medical condition occurs or arises, I hereby give permission to the ANA Enterprise, its subsidiaries and affiliates, and any of their officers, directors, servants, agents, and employees to seek emergency treatment. I understand that I am financially responsible for the resulting charges.

PHOTO RELEASE

In connection with my participation in the Program, I, the undersigned, do hereby give and grant to the ANA Enterprise, and its assigns, licensees, and legal representatives, the irrevocable right to use my name and likeness, including without limitation photographs, portraits, audio, and video, taken of me in any manner, in all forms and media now existing or subsequently developed and in all manners (the “Property”), for any lawful purpose throughout the world, in perpetuity, and I waive any right to inspect or approve the finished version(s), including written copy that may be created and used in connection therewith.  This grant includes, without limitation, the right to edit, mix, and otherwise alter or duplicate the Property as ANA Enterprise may elect.

I also grant to ANA Enterprise the right to quote and otherwise use and attribute to me, at its sole discretion, my oral or written statements (which shall be deemed part of the Property), in all the manners described above.

I understand that ANA Enterprise is not obligated to use any of the rights granted hereunder, or to prepare, produce, exhibit, distribute, or exploit the Property. I understand that I will not receive any monetary compensation for the permissions granted hereunder. ANA Enterprise shall be the owner of the Property and I waive any claims against ANA Enterprise for use of the Property.

BY SIGNING THIS FORM, I STATE THAT I HAVE READ AND UNDERSTAND THE CONDITIONS SET FORTH IN THIS RELEASE AND WAIVER OF LIABILITY AND THAT I AGREE TO ALL CONDITIONS SET FORTH HEREIN, AND THAT I SIGN THIS VOLUNTARILY.
1. BY SIGNING THIS FORM, I STATE THAT I HAVE READ AND UNDERSTAND THE CONDITIONS SET FORTH IN THIS RELEASE AND WAIVER OF LIABILITY AND THAT I AGREE TO ALL CONDITIONS SET FORTH HEREIN, AND THAT I SIGN THIS VOLUNTARILY.
  *This question is required.