I assume responsibility for any and all risk of property damage or bodily injury that I may sustain while participating in or traveling to and/or from any activity conducted by United Way Fox Cities and Valley Packaging Industries, Inc. (VPI). In the event of an accident, injury, illness, or property damage, United Way Fox Cities and VPI and their agents do not assume any responsibility or obligation to provide financial assistance or other assistance, including but not limited to, medical, health, or disability insurance. I currently have no known mental or physical condition that would impair my capability for full participation as intended or expected of me and I assume full responsibility for my medical condition as it relates to my participation. I further acknowledge that I have adequate insurance necessary to provide for and pay any and all medical costs that may directly or indirectly result from my participation. I further acknowledge my participation has inherent risks that I choose to accept voluntarily, and that my choice to participate in these activities can be discontinued at any time at my sole discretion. I agree to obey all laws and regulations for any and all activities I will participate in. I further agree to use all equipment provided as it is intended to be used and leave it in the condition and location that I find it.
I, on behalf of myself, my heirs, legatees, personal representatives, and all those claiming by or through me, also consent to, and do hereby discharge, release and forever hold harmless United Way Fox Cities and VPI, their Board of Directors, officers, shareholders, attorneys, sponsors of this program, their affiliates, agents, servants, employees, assigns, successors and heirs (the "Released Parties") from any and all claims, actions, losses, damages, or expenses related to personal or bodily injury (including death) and property loss or damage incurred by me, arising indirectly or directly out of United Way Fox Cities' or VPI's negligence. This Release contemplates discharging the Released Parties solely for the tort of negligence and does not release or discharge the Released Parties for any other causes of action, including, without limitation, intentional, reckless, wanton, willful or intentional conduct.
I acknowledge that this Release was signed by me with the express intention of giving up substantial rights, including effecting the extinguishment of certain obligations that may be owed to me. I release and discharge the Released Parties freely and voluntarily with the intention of binding my spouse, heirs, executors, administrators, legal representatives and assigns. I have been given the opportunity to bargain and negotiate different terms related to this Release and have been encouraged by United Way Fox Cities and VPI to seek independent legal advice prior to signing this Release.
This Release shall be construed in accordance with the laws of the State of Wisconsin. The invalidity in whole or in part of any provision of this Release shall not affect the validity of any other provision. Subject to amendments or changes to the terms of this Release by the signatories, the signed Release shall constitute the entire agreement of the parties with respect to the subject matter of this Release and supersedes all prior agreements, understandings, negotiations, statements, promises and discussions, oral and written, between the parties hereto with respect to the subject matter of this Release.
I hereby grant United Way Fox Cities and Valley Packaging Industries, Inc. (VPI) permission to use my likeness in a photograph, video, audio recording, or other media in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all media will become the property of United Way Fox Cities or VPI and will not be returned. I hereby irrevocably authorize the United Way Fox Cities and VPI to edit, alter, copy, exhibit, publish, or distribute these photos or other media for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. By signing below, I hereby hold harmless, release, and forever discharge United Way Fox Cities and VPI from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
Please complete and submit the remainder of this form for the Liability Release. Individuals who do not consent to the liability release are unable to participate as a volunteer.
Valley Packaging Industries, Inc. (VPI) Visitor Non-Disclosure and Waiver Agreement
During my visit to your facility, I will learn and/or have disclosed to me proprietary or confidential information (including, without limitations, information relating to technology, trade secrets, processes, materials, equipment, drawings, specification, prototypes and products) and may receive samples of products which are not generally known to the public (hereinafter collectively called "Confidential Information").
In consideration of your permission to visit your facility & for the courtesies extended to me during my visit:
I agree that I will not, without your written permission or that of your authorized representative either;
(a) Disclose or otherwise make available to others any Confidential Information disclosed to me during this and any subsequent visit which was not known to me or my organization prior to disclosure by you, or is not now or subsequently becomes a part of the public domain as a result of publication or otherwise.
(b) Use or assist others in using or further developing in any manner any confidential information.
(c) Use cameras or video technology to disclose confidential information.
I also agree to conform to any applicable safety requirements, which are brought to my attention by any employee or by signs posted in the areas that I visit while on the premises, and to observe other reasonable safety precautions.
I further agree to release VPI, it's officers, agents, employees, invitees or licensees from all claims, losses expenses (including attorney's fees), interest, damage and liability to the extent caused by or resulting from my negligence or willful misconduct.
Please be advised by signing into the facility, you have acknowledged and understand the Safety Protocols, Visitor Guidelines and Non-Disclosure Agreement posted.
Volunteers under the age of 16 must be accompanied by a parent/guardian. Volunteers under the age of 18 must obtain the required consent of a parent/guardian.
TERMS OF ACCEPTANCE and SIGNATURE As a volunteer for United Way Fox Cities, I warrant the truthfulness of the information provided in this form.
Thank you for completing this survey.