Consent Form
In consideration for being permitted to participate in Lives on the Registry (“the Project”), a project of National Association for Rational Sexual Offense Laws (“NARSOL”), the undersigned, for himself or herself and such participating household members (individually and collectively, the “Participant”), hereby releases and agrees to hold harmless NARSOL and its directors, agents, employees, volunteers, sponsors, independent contractors, officers, or other affiliated entities, and all other persons or entities acting on its behalf (together, the “Released Parties”), together with their successors and assigns, from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from the Participant’s past, current or future participation in the Project. The Participant voluntarily desires to participate in the Project and any travel required. The Participant understands that publication of stories and photos may create a risk to the Participant. The Participant acknowledges these hazards and voluntarily assumes any and all the risks of loss, damage or injury associated with such participation.
Waiver and Release: The Participant understands and acknowledges that this Release discharges the Released Parties from any liability or claim that the Participant may have against the Released Parties with respect to bodily injury, personal injury, illness, death, property damage or any other damage that may result from the Participant’s participation in the Project.
Insurance: The Participant understands that the Released Parties do not assume any responsibility for or obligation to provide the Participant with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. The Participant expressly waives any such claim for compensation or liability on the part of the Released Parties beyond what may be offered freely by the Released Parties in the event of injury or medical expenses incurred by the Participant.
Medical Treatment: The Participant hereby releases and forever discharges the Released Parties from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services, including counseling, therapy or any mental health associated treatment, rendered in connection with any event during the Participant’s participation in the Project.
Photo and Video Disclaimer: NARSOL reserves the right to use any photograph/video received or taken as a part of the Project without the permission of those included within the photograph/video. NARSOL may use the photograph/video in publications or other media material produced, used or contracted by NARSOL including but not limited to: brochures, invitations, books, newspapers, magazines, television, websites, etc. To ensure the privacy of individuals and children, images will not be identified using full names or personal identifying information without written approval from the photographed subject, parent or legal guardian.
Other: The Participant agrees that this Agreement is intended to be as broad and inclusive a release of liability as permitted by law, and that if any portion thereof is held invalid, it is agreed that the remaining balance of this Release shall continue in full legal force and effect. The Participant agrees that binding arbitration before a single arbitrator pursuant to the Rules of the American Arbitration Association shall be the exclusive means of resolving all disputes arising out of or relating to this Agreement or participation in the Project. The Participant understands that they may revoke this agreement solely with respect to future participation by sending written notice of revocation to NARSOL, PO BOX 36123, ALBUQUERQUE, NM 87176 (which shall be effective not less than 10 days after receipt). NARSOL will remove any posted information from its website and discontinue any future printed media that contains the Participants’ information and/or image(s). Participant agrees not to pursue or participate further in the Project after such revocation.
By signing below via digital signature, the Participant expresses understanding and intent to willingly and voluntarily surrender and waive any rights to sue or exercise any legal right to seek any actual, direct, indirect, incidental, special, exemplary, punitive or consequential damages from any of the Released Parties, either under this Agreement or under any theory of contract, tort, wrongful death, negligence, strict liability, statutory liability, warranty or otherwise.
THE PARTICIPANT HAS READ AND VOLUNTARILY SIGNS THIS AGREEMENT, and further agrees that no oral representations, statements or inducements apart from the foregoing written agreement have been made.
NOTE: When you click “Submit,” you will be shown a confirmation of submission and be given a link to the full Submission Form.
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