Charity Fundraiser Media Waiver and Liability Form

Participant Information

Full Name Email Address

Phone Number

Date

Media Waiver

I hereby grant and authorize the organizers of this charity fundraiser event the right to take, use, and publish photographs/video of me in connection with the above-identified event for promotional, educational, or any other lawful purpose.

I have read and agree to the Media Waiver.

Liability Release

I hereby release and hold harmless the event organizers, sponsors, and volunteers from all liability, claims, or demands that may arise from my participation in this event.

I have read and agree to the Liability Release.

Signature

Signature Date