Parent/Guardian Waiver & Release Form

This is a medical waiver of liability and media release indemnification for Indiana Black Expo, Inc. and its sponsors, partners, venues, and their owners. I, being a parent or legal guardian (both referred to herein as “Parent”) (“Child”) and not being an employee of the Parties nor any individual Party, desire for my Child to participate in all activities included as a part of the IBE Youth & Family Year-Round Programs and specifically, by his/her participation in physical endeavors (“Activities”) offered or hosted during the IBE Summer Celebration and Circle City Classic®.

I fully understand the risks involved and that it is possible for my child to sustain serious injury, permanent disability, and/or death during the course of said Activities. However, in partial consideration of the opportunity for my Child to participate in the Activities, I individually and for my Child covenant not to sue and forever discharge the Parties, their respective venues, vendors, sponsors, subcontractors, volunteers, agents, partners, officers, directors, employees, trainers, physicians, licensees, lenders, subsidiaries, representatives, shareholders, agents, insurers, successors, and assigns (hereinafter collectively known as “Releasees”) from any and all liability to the undersigned, my Child, my Child’s other Parent, personal representatives, assigns, heirs and next of kin for any and all loss and damage, and any claim or demands therefore on the account of any injury, illness or death suffered by my Child in connection with the Activities, whether caused by sole or concurrent negligence of Releasees or otherwise. I, individually and for my Child and my Child’s other Parent, further do hereby indemnify and hold harmless said Releasees against all losses and/or expenses (including but not limited to legal fees) that they may incur as a result of claims made as a result of my Child’s participation in the Activities.

These programs will ask my child if he/she would like to participate in voluntary surveys. My child’s name will NOT be used on surveys! I hereby give Indiana Black Expo, Inc., permission to use and authorize others (media outlets) to use all or any part of my (his/her) interview/photograph/video in IBE-related media such as books, magazines, journals, pamphlets, electronic (Internet) and other written and video formats, regardless of the medium by which it is recorded. I warrant and represent that I have been authorized by my Child’s other Parent to execute this release for my Child’s other Parent.