Sam Chheong Memorial Roll-A-Thon Check-In

Please complete this form before participating.

First Name*

Last Name*

Email Address*

Phone Number*

Gym / Organization

Waiver of Liability and Assumption of Risk

WAIVER OF LIABILITY AND ASSUMPTION OF RISK

SAM CHHEONG MEMORIAL ROLL-A-THON

I understand and acknowledge that participation in the Sam Chheong Memorial Roll-A-Thon involves physical activity, including but not limited to Brazilian Jiu-Jitsu, grappling, fitness activities, and related training or demonstrations.

I understand that these activities carry inherent risks, including but not limited to bodily injury, permanent disability, paralysis, illness, or death, as well as property damage or loss. I voluntarily choose to participate with full knowledge of these risks.

I certify that I am physically fit and have not been advised otherwise by a qualified medical professional. I agree that I am solely responsible for my health, safety, and well-being during this event.

In consideration of being permitted to participate, I hereby release, waive, discharge, and hold harmless the Hero Down Foundation, its officers, directors, employees, volunteers, contractors, sponsors, partners, venue owners, instructors, and affiliates from any and all claims, demands, actions, or causes of action arising out of or related to my participation in this event, including those caused by negligence, to the fullest extent permitted by law.

I agree to indemnify and hold harmless the released parties from any loss, liability, damage, or cost they may incur due to my participation.

I understand that this waiver applies to all activities associated with the event, including travel to and from the event, and remains in effect for the duration of my participation.

I acknowledge that I am participating voluntarily and without coercion.

By checking the box below, I confirm that I have read, understand, and agree to this Waiver of Liability and Assumption of Risk.

[acceptance* waiver-consent] I have read and agree to the Waiver of Liability and Assumption of Risk.

Media Release and Authorization

MEDIA RELEASE AND AUTHORIZATION

I grant permission to the Hero Down Foundation and its representatives to photograph, record, and capture my image, likeness, voice, and participation during the Sam Chheong Memorial Roll-A-Thon.

I authorize the use of these photographs, video recordings, and audio recordings for lawful purposes including promotional materials, social media, websites, fundraising materials, and other communications related to the mission of the Hero Down Foundation.

I understand that I will not receive compensation for the use of these materials and that I waive any right to inspect or approve the finished product.

I release and hold harmless the Hero Down Foundation from any claims related to the use of my image or likeness, including claims of invasion of privacy, defamation, or misrepresentation.

This authorization is voluntary and remains in effect unless revoked in writing prior to the event.

[acceptance* media-consent] I have read and agree to the Media Release and Authorization.