Registration Form 2015

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Waiver of Liability Terms Agreement

In consideration of your acceptance of this entry, I__________________________


(BLOCK CAPITALS) hereby, for myself, my heirs, executors and administrators,
and my assignees, waive and release all rights and damages I may have against
Ballinode Community Projects Ltd., any and all sponsors of the event and their
representatives for any and all injuries incurred by me in conjunction with this
competition and in travelling to and from the event. I hereby grant to Ballinode
Community Projects Ltd., as organisers of Shed A Load, and/or any other
approved broadcast, newsprint, video, internet or other entertainment
organisation, and all of their associated agents, successors, licensees and
assignees, the right to record, photograph or otherwise reproduce (whether by film,
tape, still photography or otherwise) my voice, likeness and name, and to exhibit,
distribute, transmit and/or exploit any and all other media resources, including but
without limitation, by means of still photography, motion picture, radio broadcast,
television broadcast, televised motion pictures, video recording, printing (whether
for advertising or in newsprint), or by any other medium now known or hereafter
devised, including with respect also to any and all merchandising and/or publicity,
and the right to use my name, likeness and any personal information provided by
myself about me in any connection with any of the foregoing. The rights granted by
me hereunder are granted for the entire universe and shall endure in
perpetuity,
and no further compensation shall be payable to me at
anytime in connection
therewith.
I
understand that Ballinode
Community Projects Ltd., and/or any other
approved video or broadcasting/entertainment organisations are recording,
videotaping and photographing the event in express reliance upon the foregoing,
and I represent and agree that I am free to grant these rights to Ballinode
Community Projects Ltd.,
and/or
any other
approved
video
or
broadcasting/entertainment organisations hereunder.
I acknowledge and fully understand the terms of this agreement and consent to its
implementation of my own free will.

Signed: ________________________________

Date: ___/___/_____.

Witness: _______________________________

Date: ___/___/_____.

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