Creative Immersion Retreat
Injury Waiver & Photo Release
Monica Fogg Studio, LLC
PARTICIPANT INFORMATIONName (print or type)
Address Phone/s |
EMERGENCY CONTACT INFOName (print or type)
Relationship to Participant Phone/s |
HOLD HARMLESS
I hereby acknowledge that I have voluntarily applied to participate in painting activities in Mexico. I understand that the activity of travel and plein air painting & sketching presents the possibility of injury. I therefore expressly assume all risks of personal injury, including death and damage to personal property sustained during this Creative Immersion Retreat and release Monica Fogg, Monica Fogg Studio LLC, and fellow participants from any and all liability for all injury, death or damages, suffered by me during the participation in this event whether due to negligence of the Released Parties, their respective agents or peers.
I agree to defend. indemnify and hold harmless the Monica Fogg Studio LLC, Monica Fogg, and any other Released Parties against
any and all actions, suits, claims, demands, causes of actions, proceedings, losses, costs, all expenses, without limitation, including;
all attorneys fees and disbursements, damages, liabilities, losses, fines or penalties in any way arising out of, or related to, connected with directly or indirectly this Minnesota Sailing Alliance sailing activity, regardless of whether there is active or passive negligence or fault on the part of Monica Fogg Studio LLC, Monica Fogg, and any other Released Parties.
I here by fully and forever release and discharge Monica Fogg Studio LLC, their employees, agents and members from any and all claims, demands, damages, or causes of action present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of my intended participation in MSA events. I have carefully read this release of liability and understand, agree with and accept its terms and conditions.
This release also authorizes the use of photos taken for Monica Fogg Studio for any and all commercial or non-commercial purposes.
I hereby acknowledge that I have voluntarily applied to participate in painting activities in Mexico. I understand that the activity of travel and plein air painting & sketching presents the possibility of injury. I therefore expressly assume all risks of personal injury, including death and damage to personal property sustained during this Creative Immersion Retreat and release Monica Fogg, Monica Fogg Studio LLC, and fellow participants from any and all liability for all injury, death or damages, suffered by me during the participation in this event whether due to negligence of the Released Parties, their respective agents or peers.
I agree to defend. indemnify and hold harmless the Monica Fogg Studio LLC, Monica Fogg, and any other Released Parties against
any and all actions, suits, claims, demands, causes of actions, proceedings, losses, costs, all expenses, without limitation, including;
all attorneys fees and disbursements, damages, liabilities, losses, fines or penalties in any way arising out of, or related to, connected with directly or indirectly this Minnesota Sailing Alliance sailing activity, regardless of whether there is active or passive negligence or fault on the part of Monica Fogg Studio LLC, Monica Fogg, and any other Released Parties.
I here by fully and forever release and discharge Monica Fogg Studio LLC, their employees, agents and members from any and all claims, demands, damages, or causes of action present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of my intended participation in MSA events. I have carefully read this release of liability and understand, agree with and accept its terms and conditions.
This release also authorizes the use of photos taken for Monica Fogg Studio for any and all commercial or non-commercial purposes.
Event to which waiver is in effect: Creative Immersion Retreat
Signature date
I certify that I am at least 18 years of age
I certify that I am at least 18 years of age
Please fill out, sign, scan and email to [email protected]