Participant/Photo Waiver

Poudre Heritage Alliance – REQUIRED Participant/Photo Waiver

Completion of the waiver below is a REQUIREMENT of participation in Poudre Heritage Alliance programs such as On the Trail to Health, Heritage, and Happiness. Please complete/sign the participant/photo waiver form below – this is required of every employee of your organization participating in the program. You only need to complete the waiver form once during your participation in this year-long program. If your child (under age 18) is appearing in any of your “seasonal selfies,” please also complete the portions of the form that refer to child participants (if you have more than one child participating, we ask that you please fill out the form multiple times). Sharing your photos will help the National Park Foundation promote the Active Trails initiative to a broad array of stakeholders, including potential donors and will help the Cache la Poudre River National Heritage Area continue to broaden its reach and share this program with the community. Thank you for your assistance in fulfilling the requirements of the National Park Foundation – Active Trails Program and the Poudre Heritage Alliance.

Participant and Photo/Media Release

I agree to participate in the 2016 Active Trails Program (“Program”) and that all text and images submitted to The National Park Foundation (“NPF”) / Cache la Poudre River National Heritage Area/Poudre Heritage Alliance (“Sponsors”) associated with the Program may be used and re‑used by the Sponsors for purposes of illustration, advertising, promotion, display or publication, and for any other lawful, non-commercial use. This consent has no limits as to media, territory or time. I understand that these images may be cropped, edited or otherwise altered and that whether any of them is used, and how it is used, is entirely for Sponsor (or its licensees) to decide. I hereby relinquish all rights to review or approve any such use. I hereby authorize the Sponsors to use my name and any biographical data I may provide in connection with this project. I hereby represent and warrant that: I have full authority to grant this consent and release. Nothing herein violates the terms of any affiliation I may have with any third party and I take full responsibility for satisfying all obligations arising from any such affiliation. I HEREBY RELEASE THE NATIONAL PARK FOUNDATION, CACHE LA POUDRE RIVER NATIONAL HERITAGE AREA, POUDRE HERITAGE ALLIANCE, THEIR SUBSIDIARIES, AFFILIATES, SUCCESSORS AND ASSIGNS, TOGETHER WITH THEIR OFFICERS, DIRECTORS, EMPLOYEES, REPRESENTATIVES, AGENCIES AND LICENSEES, FROM ALL LIABILITY IN CONNECTION WITH ANY USE OF THESE ASSETS.

Your Organization*
Employee ID/ Troop ID/ School and Class
Your Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Participating Child
Participating Child's Name
If your child is participating: I hereby irrevocably give my consent for my son/daughter/legal dependent to participate in the 2016 Active Trails Program as described above (Enter child's name)
Participating Child's Age
Parent/Guardian Name
Signature
Today's Date*
MM slash DD slash YYYY
Your Signature (re-enter name)*
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Participant and Photo/Media Release

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