WAIVER OF LIABILITY & CONSENT TO USE NAME, PHOTOGRAPH, FILM VOICE, ON RADIO, TELEVISION AND IN PRINT MEDIA

I agree to participate in the Flint City Bucks’ Free Soccer Clinic at Kettering’s Atwood Stadium at my own risk. In consideration for being permitted to participate in this event, I agree that I shall hold the Flint City Bucks, Flint Premier Soccer, LLC, Kettering University, Atwood Stadium, Hurley Medical Center, and Kohl's, their affiliates or volunteers, shareholders, directors, officers, employees, representatives and agents (collectively, "Program Entities") harmless from any and all loss, claim, injury, damage or liability sustained or incurred by me resulting therefrom, even if the injuries or damages arise as a result of negligence or culpable conduct on the part of the parties released. I further agree to indemnify and hold harmless the Program Entities for all claims against the released parties for expenses incurred by the released parties which are due to my participation in any and all programs.

I consent to and authorize each of the Program Entities to use, reuse, edit, modify and/or publish audio, videographic and other materials containing my photograph, likeness, image, and/or voice and/or words, including my testimonial statements, in connection with the event and other related or derivative materials (collectively, the "Materials") for use in printed publications, collateral, invitations, newspaper ads, billboards, radio, television, social media and website. I further grant the right to license others to use and reuse the Materials in the same manner. I do hereby waive the right to inspect and/or approve such Materials. I acknowledge that since participation in publications and websites produced by the Program Entities is voluntary, I will not receive financial compensation.

I understand that I have a right to rescind consent for the use of this information up until a reasonable time before the information is used. If I wish to rescind consent, I must do so in writing. I understand that I will need to provide a written statement to revoke this release of information and mail it to Public Relations Manager, Hurley Medical Center, One Hurley Plaza, and Flint, MI 48503. I also understand that the revocation will not apply to information that has already been used, but will apply to any future use.

I further agree that participation in any publication and website produced by any of the Program Entities confer no rights of ownership whatsoever. I release these parties from liability for any claims by me or any third party in connection with my participation. The Program Entities and I expressly agree that this Waiver is intended to be as broad and inclusive as permitted by the laws of the State of Michigan, and that this Waiver shall be governed by and interpreted in accordance with the laws of the State of Michigan. The Program Entities and I agree that in the event that any clause or provision of this Waiver shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Waiver which shall continue to be enforceable.

As the parent or legal guardian, I have read, understand and acknowledge this agreement on behalf of my child.