Liability & Media Release


This Photo Release and Waiver of Liability (“Release”) is in favor of Chicago Union Ultimate LLC and Chicago Union Cares Inc. (individually and collectively the “Chicago Union”) and is executed by the participant, the parent or guardian of the participant, the volunteer, or the parent or guardian of the volunteer who is involved in a program or event hosted, organized, sponsored, or paid for by the Chicago Union.

I agree the Chicago Union is authorized to film, tape, record, and photograph me, my voice, and my likeness for editorial, commercial, and fundraising purposes. I grant the Chicago Union permission to make changes or alterations for such purposes, provided that any identification by my actual name requires my prior written consent. I agree the Chicago Union is the exclusive owner of the results and proceeds of such filming, taping, recording, and photography with the right throughout the world, in perpetuity, to copyright, use, and license others to use, all or any portion thereof in any and all media (including but not limited to broadcast and internet) as the Chicago Union shall determine in its sole discretion. I waive any right of inspection or approval of such use.

I acknowledge that the risk of injury from involvement in Chicago Union programs and events is significant, including the potential for permanent disability and death, and, while rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the Chicago Union or others. I assume full responsibility for my participation. I willingly agree to comply with the Chicago Union’s stated and/or customary terms and conditions for participation. If I observe any unusual significant concern in my readiness for participation and/or in the program or event itself, I will remove myself from participation and bring such attention to the nearest official or Chicago Union representative immediately.

I hereby release and hold harmless the Chicago Union, its directors, officers, members, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, the owners and lessors of premises, with respect to any and all injury, disability, death, or loss or damage to person or property incident to my involvement or participation in Chicago Union programs or events, whether arising from their negligence or otherwise, to the fullest extent permitted by law.

I, and on behalf of my heirs, assigns, personal representatives and next of kin, hereby indemnify and hold harmless all the above parties from any and all liability incident to my involvement or participation in these programs or events, even if arising from negligence or otherwise, to the fullest extent permitted by law.

I give permission to licensed EMTs, physicians, paramedics, athletic trainers, physical therapists, and other medical or hospital personnel to render treatment.

I agree that any and all permissions and releases granted by me, and all rights waived by me, also extend to my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin.

By signing below, I affirm that that I understand and voluntarily agree to the terms of this Photo Release and Waiver of Liability, without duress, and for adequate consideration. I further affirm that I am 18 years of age or older and signing on my behalf as a participant or volunteer and/or, if I am the parent or guardian of a participant or volunteer who is under the age of 18, that I am also signing on their behalf.

Signature: ______________________________

Printed Full Name: ___________________________

Date: _______________

If Applicable, Full Name of Child: _________________________