I understand there is no fee for the Nevada Partners Positive Youth Impact Program. PLEASE READ THIS PARTICIPATION AGREEMENT FORM CAREFULLY. IT IS A LEGAL CONTRACT CONTAINING AN IMAGE/VOICE PERMISSION, RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNIFICATION, AND MEDICAL EMERGENCY PERMISSION, AND IT AFFECTS ANY RIGHTS YOU MAY HAVE IF YOU OR YOUR CHILD ARE INJURED OR OTHERWISE SUFFER DAMAGES WHILE PARTICIPATING IN THE POSITIVE YOUTH IMPACT PROGRAM AT NEVADA PARTNERS. Please print a copy of this form for your records. This form needs to be electronically signed by both the Youth (participant) AND his/her parent or guardian (if youth is under the age of 18).

By electronically signing this Participation Agreement, I agree to the following: I (and/or my minor child/children) volunteer willingly to participate in the Nevada Partners Positive Youth Impact Program at Nevada Partners I (and/or my minor child/children) will only participate in activities that safely meet skill and ability levels. I understand that the Nevada Partners Positive Youth Impact Program does not provide health insurance for me (and/or my child/children). I understand that a staff member/ representative will attempt to contact the parent, guardian, or emergency contact listed on the Parent/Guardian Medical Release of a Minor Form in case of illness or injury. I authorize these representatives to contact paramedics and/or take me/my child to a hospital and be given treatment by paramedics and hospital staff as necessary. I understand that I (and/or my minor child/children) will bear all financial responsibility for any medical treatment arising from participation in the Nevada Partners Positive Youth Impact Program. I understand that Nevada Partners reserves the right to require that I (or my child/children) withdraw at any time when in their sole judgment, it is not physically safe to continue participating. I (and/or my minor child/children) are in good health and will inform the Facilitator or Youth Program Manager of any health issues that may be of concern during any of the programing/workshops. I (and/or my minor child/children) have obtained all required immunizations set forth by the Southern Nevada Health District and/or Clark County Department of Education before attending programing/workshops at Nevada Partners Positive Youth Impact Program. I (and/or my minor child/children) will abide by the Safety Rules and Campus Regulations.

Photographs or video/audio recordings may be taken of you and/or your child/Youth during this sessions. Unless you request otherwise, this Participation Agreement will be considered permission for Nevada Partners to photograph, film, audio/video tape, record and/or televise your image and/or voice or the image and/or voice of your child/children for use in any publications or promotional materials, in any medium now known or developed in the future without any restrictions. If you object to using your image or voice or your child’s/children’s image or voice in this manner, please notify the Youth Program Manager, Ela Garcia ([email protected]), in writing, upon submission of this Agreement.

I understand that there may be inherent dangers associated with the Nevada Partners Positive Youth Impact Program. These dangers include but are not limited to burns, cuts, loss of eyesight, personal injury, or even death. I assume full responsibility for any risk of loss, property damage, or personal injury that may be sustained by me or my child/children, or any loss or damage to property owned by me or my child/children as a result of participation in the Nevada Partners Positive Youth Impact Program at Nevada Partners. I hereby RELEASE FROM LIABILITY, WAIVE, DISCHARGE AND COVENANT NOT TO SUE NEVADA PARTNERS, INC., and any of the officers, servants, agents and employees of the above-mentioned entities (hereinafter referred to as RELEASEES) for any liability, claim and/or cause of action arising out of or related to any loss, damage or injury, including death, that occurs as a result of participation in the specified activities. I also ASSUME THE RISKS of my participation and my child’s/children’s participation in the specified activities and agree to not hold the RELEASEES responsible for any loss, damage or injury, including death that occurs as a result of participation in the specified activities. I further agree to INDEMNIFY AND HOLD HARMLESS the RELEASEES whether the injury is caused by my or my child’s/children’s negligence, the negligence of the RELEASEES or the negligence of any third party. I further agree that this PARTICIPATION AGREEMENT shall bind the members of my family and spouse if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this PARTICIPATION AGREEMENT shall be construed in accordance with the laws of the State of Nevada. By electronically signing this PARTICIPATION AGREEMENT, I state that I have read, understand, and agree to the conditions set forth herein and that I sign this form freely and voluntarily.