Glow Walk Run 2021

Start Date:
Saturday, October 23, 2021
End Date:
Saturday, October 23, 2021
Location:
Liberty State Park
1 Audrey Zapp Drive (Ferry Parking Lot)
Jersey City, NJ 07305

Event Time: 2:00pm - 6:00pm

Contact: Jennifer Gleason

Phone: 609-392-4900 Ext. 119

Email: jgleason@epilepsynj.org

 


Glow Walk Run Participant Waiver

I understand that I am voluntarily participating in the event(s) at my own risk and my own request. I hereby waive all claims against The Family Resource Network and its affiliates, sponsors, or any event personnel, paid or volunteer, for any injury I might suffer during this event. The guardian must remain onsite for the duration of the event.

I do hereby consent and agree that The Family Resource Network (FRN), and all other affiliates/programs under The Family Resource Network, its employees and agents have the right to take photographs, videotape, or digital recordings of me/my child during my/my child's participation in the Glow Walk run event to use in any and all media forms including; advertising, publications, website, internet and social media. This (these) photograph(s)and/or digital recordings may be used indefinitely as part of the above-mentioned program and may also be used to promote to educational or health professionals, referral sources, and/or the general public in print and/or electronic format. I do hereby release to The Family Resource Network, and all other affiliates/programs under The Family Resource Network, its employees and agents, all rights to exhibit this work of myself/my child in print and electronic form for publicity or privately.

I further consent that my/my child's name and identity may be revealed therein or by descriptive text or commentary. I understand that I can withdraw my permission for future publication and that upon my written request, the photograph(s) and/or digital recordings will not be re-published for future circulation. This will not affect my/my child's relationship with The Family Resource Network or staff in any way. I understand that I/my child will receive no financial or other reimbursements for recording, photographing, or videotaping me/my child, either for initial or subsequent transmission or playback.

Purchasing tickets below means that I have read and understand this form; and that I am giving consent to be photographed and/or recorded during my/my child's participation in Glow Walk Run, thereby granting permission for the use of my/my child's photograph in any publication or advertising material (printed or electronic) of The Family Resource Network, and all other affiliates/programs under The Family Resource Network, its employees and agents. This consent also serves to waive all rights of privacy and compensation which me/my child may have in connection with the use of my/my child's photograph.

I represent that I am at least 18 years of age or am the parent or legal guardian of said child below and have read and understand the above statements and will execute this agreement.