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Consent Form – Laurentides, Lanaudière & Outaouais Respite
Consent Form - Laurentides, Lanaudière & Outaouais Respite
Consent form - Laurentides, Lanaudière, Outaouais Respite
Consent form for adults and children over 14 years old
Consent
I authorize that photos and videos taken of myself during the activity be used to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year.
Consent
I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent
I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Consent for another participant over 14 years old
Yes
No
Consent
I authorize that photos and videos taken of myself during the activity be used to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year.
Consent
I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent
I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Consent for another participant over 14 years old
Yes
No
Consent
I authorize that photos and videos taken of myself during the activity be used to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year.
Consent
I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent
I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Consent for another participant over 14 years old
Yes
No
Consent
I authorize that photos and videos taken of myself during the activity be used to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year.
Consent
I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent
I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Consent for another participant over 14 years old
Yes
No
Consent
I authorize that photos and videos taken of myself during the activity be used to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year.
Consent
I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent
I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Consent for another participant over 14 years old
Yes
No
Consent
I authorize that photos and videos taken of myself during the activity be used to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year.
Consent
I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent
I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Consent form for children under 14 years old
Name
First name
Last name
Add another participant under 14 years old
Yes
No
Name
First name
Last name
Add another participant under 14 years old
Yes
No
Name
First name
Last name
Add another participant under 14 years old
Yes
No
Name
First name
Last name
Add another participant under 14 years old
Yes
No
Name
First name
Last name
Add another participant under 14 years old
Yes
No
Name
First name
Last name
Add another participant under 14 years old
Yes
No
Name
First name
Last name
Consent
I authorize that photos and videos taken of my child during the activity be used to represent Leucan's mission. I authorize that my child's name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year.
Consent
I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent
I acknowledge that my child's participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from their participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my child's participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that my child may suffer in connection with their participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to my child as a participant or to my child's property that may arise or occur in connection with their participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the parent/legal guardian), authorizes the children mentionned above to participate in this activity and accept the terms and conditions of this activity.
First name
Last name
Partners
All our partners
