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Leadership Conference Consent Form

Please fill out and submit the Leadership Conference Consent form below. This form must be signed by you (and your parent/guardian, if applicable). The deadline to submit conference consent is June 15, 2019.

If you are a registered Best Buddies Online user, please login below before completing the form.

 
 

Attendee Information

Please enter the name, date of birth, and chapter (if applicable) of the Leadership Conference attendee below.

Please enter a valid birthdate

Please click here if you do not have an e-mail address.
If you are not representing a Best Buddies chapter, or are representing an International chapter, please click here.

Medical Release

I, the undersigned, hereby authorize Best Buddies International, Inc., a District of Columbia Corporation, and its agents or assigns ("Best Buddies") to secure any medical care that should become necessary during the period commencing July 19, 2019, and ending July 22, 2019, which dates correspond to the Best Buddies International Leadership Conference.

years, I understand that Best Buddies International will only seek any such necessary medical care on the participant's behalf from duly licensed medical practitioners and hereby agree that Best Buddies International shall be indemnified and held harmless from any injuries, harm, damages, or expenses resulting from such action.

I accept responsibility for any necessary expense incurred in the medical treatment of the participant that is not covered by participant's medical insurance.

 I, , have read and agree to the terms above.
Date:  11/22/2019
 I,   , am the parent/guardian of , and I have read and agree to the terms above. Date:  11/22/2019
 
Note: Consent from a parent/guardian is required for all attendees under the age of 18 and any attendee with a court-appointed guardian.

Acknowledgment


As an attendee of Leadership Conference:
  • I understand that the use of alcohol and illegal drugs is strictly prohibited on campus during the Best Buddies Leadership Conference. I agree to refrain from drinking alcohol or using illegal drugs while on campus.
  • I agree not to leave the Indiana University campus unless accompanied by Best Buddies staff or otherwise approved by Best Buddies.
  • I understand that I may be photographed and/or filmed at the Best Buddies Leadership Conference, and I agree that any photograph or video may be used at the discretion of Best Buddies for publicity purposes. Opt Out of Photo Release
 I, , have read and agree to the terms above.
Date:  11/22/2019
 I,   , am the parent/guardian of , and I have read and agree to the terms above. Date:  11/22/2019
 
Note: Consent from a parent/guardian is required for all attendees under the age of 18 and any attendee with a court-appointed guardian.

General Release

Please accept my entry into the Annual Best Buddies Leadership Conference (hereinafter, 'Event'). I assume all responsibility for injuries and damages to me and my property that may result as an active participant in this Event.

As a condition of my entry, I hereby for myself, my heirs, executors and administrators, release, exempt and discharge and agree not to commence any lawsuit against Best Buddies International, Inc., Event subcontractors, Event sponsors, Event staff, Event volunteers, Event committee members, and cities/towns/municipalities through which the Event passes and properties on which Event festivities will take place from all claims, damages and courses of action, present or future, whether they result from, arise out of or are incident to my participation in the Event.



 I, , have read and agree to the terms above. Date:  11/22/2019
 I,   , am the parent/guardian of , and I have read and agree to the terms above. Date:  11/22/2019
 
Note: Consent from a parent/guardian is required for all attendees under the age of 18 and any attendee with a court-appointed guardian.