CONSENT & RELEASE OF LIABILITY FORM
I acknowledge that my participation in any of the activities taking place during any part of Derrick Rose Jump Store event organised by TBWA\London Ltd on behalf of adidas (UK) Limited (the "Activities") at the Derrick Rose Jump Store location in Hackney, London on or around Wednesday 10 July 2013 (the "Event") involves certain risks.
I accept and fully assume all such risks and the possibility of personal injury, death or loss of or damage to my property as a result of my participation in the Activities.
2. Release, waiver and indemnity
In consideration of TBWA\London Ltd, adidas (UK) Limited and their directors, officers, employees, agents, any member of the adidas Group and representatives (the "Organisers") allowing me to participate in the Activities, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I agree as follows:
b) to release the Organisers from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer as a result of my attendance at the Event and/or participation in the Activities due to any cause whatsoever excluding negligence on the part of the Organisers, liability in connection with proven defective product(s) supplied to the undersigned supplied pursuant to the Event and/or any breach by the Organisers of the duty of care owed under the Occupiers Liability Act; and
c) to hold harmless and indemnify the Organisers from any and all liability for any personal injury to any third party or for any property damage caused by me which results from participating in the Activities.
I declare to the best of my knowledge that I know of no reason why I should not participate in the Activities and that I am not presently suffering from (and have not suffered from) any disease or medical condition which may prevent me from participating in the Activities or which may be aggravated by my participation in the Activities.
I understand that my participation in the Activities is granted on the understanding that I understand the risks involved and accept such risks.
I understand that I must immediately inform medical personnel of any pain, discomfort, fatigue or any other symptoms that I may suffer during and after my participation in the Activities. I accept that I may be required to immediately cease or delay my participation in the Activities if so requested.
I agree to allow (at no cost) the Organisers, and/or any third party acting on the Organisers behalf, to use my name, photograph, video, voice recording and general location for publicity, news and/or any future promotions or advertising.
I hereby consent to the photography, filming and/or recording by or on behalf of the Organisers of my attendance at the Event and/or participation in the Activities (individually or collectively known as (the "Images").
I hereby assign to the Organisers, all present and future copyright and all other rights, title and interest which I may hold in the Images.
I agree to the use of the Images by the Organisers in any media format in its future promotional activities and agree that I will not make any claim for further remuneration against the Organisers, its licensees or assignees in respect of the use of the Images.
I hereby agree to waive any moral rights that I may have now or in the future in relation to the Images under the Copyright Designs and Patents Act 1988 (as amended from time to time) and, so far as is legally possible, any broadly equivalent rights I may have in any territory of the world.
5. Parent Guardian
Without prejudice to the foregoing, in the event that the undersigned is below the age of 18 years old, the parent of the undersigned ("Parent Guardian") agrees to jointly and severally guarantee and indemnify the performance of all obligations of the undersigned contained herein by signing where indicated below.
This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect.
To the maximum extent permitted by the law, the Organisers shall not be liable for any claims or actions of any kind whatsoever for damages or losses to persons and property which may be sustained in connection with my attendance at the Event.
If any of the terms and conditions of this agreement are found by a competent court or other competent body to be void or unenforceable, that term or condition shall be deemed to be deleted and the remaining terms and conditions shall remain in full force and effect.This agreement shall be governed by and interpreted in accordance with the laws of England and Wales.
The Parent Guardian and/or I (as applicable) confirm that we have read and understood this agreement prior to signing it, and are aware that by signing this agreement that we are waiving certain legal rights which we may have against the Organisers.
Signed (Undersigned) PRINT NAME Date
Signed (Parent Guardian) PRINT NAME Date
adidas UK Customer Care --United Kingdomcustomercareuk@adidas.com00800 37 87 47 37