Cow Town ThrowDown Event Waiver and Release Form (2023)

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All participants (FLL and FRC) should complete a release form.

Email *

Participant Information

Participant Name (First and Last name) *

Team Affiliation (Team Number) *

FRC or FLL participant *

FRC

FLL

The participant is attending as a . . . *

Student

Adult/Alumni Mentor/Coach

Volunteer

Other:

Read and check ALL of the following items for participation in the 2023 Cow Town ThrowDown Event

INJURY/DAMAGE RELEASE *

I understand that participation in the Cow Town ThrowDown Robotics Invitational is voluntary and that the activity carries some physical risk. I agree to assume the risk of any illness, injury or damage to myself or personal property resulting from my participation in this activity. I hereby release and discharge Lee's Summit R-7 School District and Cerner Corporation and their respective officers, directors, employees and agents from all liabilities, claims, demands, controversies, damages, actions and causes of action, which result from or arise out of the participation by me in this activity.

CLAIMS RELEASE *

I hereby release Lee's Summit R-7 School District and Cerner Corporation and their respective officers, directors, employees and agents generally from all claims, including but not limited to claims for bodily injury, death or property damage arising from my participation in the activity and the use of Lee's Summit R-7 School District facilities by me. I assume responsibility for all liability in connection with such claims and agree to indemnify Lee's Summit R-7 School District and Cerner Corporation against any such claims and related costs, including claims by any minor which may be brought after attaining majority.

MEDIA RELEASE *

Cow Town ThrowDown Robotics Invitational participants irrevocably grant, at no cost to Lee's Summit R-7 School District the absolute right and permission to use their name, voice, image, likeness, biographical materials world‐wide, in perpetuity, in all forms of media now and forever known, including video footage, for the sole purposes of advertising, promoting, reporting and disseminating information regarding the Cow Town ThrowDown Robotics Invitational and Cow Town ThrowDown Robotics Invitational participants.

E-Signature

The name of the person completing this form should be entered below. The person signing the form must be 18 years of age. If the participant is under 18 years of age, a legal parent/guardian must sign below.

I have read and fully understand and accept each of the above conditions for participation in this activity.

I hereby represent and warrant by my signature, that I am 18 years of age or I am the legal parent or guardian of the participant listed above.

I understand that checking this box constitutes a legal signature that I acknowledge and agree to the above terms.

Full Name of person completing form (must be 18 years or older) *

A copy of your responses will be emailed to the address you provided.

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