This Liability Waiver & Release Form (the “Agreement”) is entered into by and between 10,000 Degrees (the “Organization”) and the person or persons attending and/or participating in the event (the “Participant”).

1.     Voluntary Participation. Participant understands and confirms that participation in any event offered by the Organization is voluntary. The Participant warrants that s/he/they is/are in overall good health and that no bodily or mental condition would create an unreasonable risk of harm to himself/herself/themselves in participating in any activities or games at an event that requires physical or mental exertion.

2.     The Assumption of Risk. Participant understands and acknowledges that there may be potential risks involved related to participation in the event. Participant assumes all risks, known and unknown, in any way connected with the participation in the event. Participant accepts full responsibility for any liability, injury, loss, damage, or death in any way connected with participation in the event. Participant acknowledges that participation in the event is at the Participant’s sole risk. Participant releases the Organization and its employees, officers, directors, agents, successors, sponsors and partners from any and all liability or claims which may arise from participation in the event.

3.     Medical Care. Participant hereby authorizes Organization and its employees, officers, directors, agents, successors, sponsors and partners to act in their best judgment should an incident or injury occur requiring medical attention. Actions taken my include providing First Aid and CPR, and calling 9-1-1 Emergency Services. Participant agrees to hold Organization harmless from any and all liabilities, claims, damages or expenses arising out of any such actions.

This form is intended for the use of obtaining permission to use images1 , testimonial and name. Why we are asking for your image & testimonial 

● A picture speaks a thousand words! And when we share your story or testimonial, it’s even more impactful. As a nonprofit that relies on outside funding, 10,000 Degrees must share the work we do so that we may raise awareness and support from the broader, global community. 

● To reflect the impact of 10,000 Degrees work through the people who’ve participated in our programs 

● To educate our audiences and increase their understanding of our work

● To inspire audiences to support our work 

How we will use your image & testimonial 

● In multiple formats for our global audience (e.g., external communications - websites, videos, flyers, email, social media, presentation slides, impact reports, strategic plans, etc. and internal communications, etc.). 

● Additional context may be added to enhance audiences’ understanding (e.g., we may include your name, 10,000 Degrees programs you attended, your high school/college, graduation year, career info, etc.) 

● We strive to represent your likeness authentically. 

Our global audience includes 

● Our internal staff, board of directors, volunteers, and program participants (students, alumni, interns, etc.) 

● Our external audiences, including: 

○ Other organizations that work with us 

○ Institutions, companies, and groups of individual donors who support our work by providing funding and other resources 

○ Media including newspapers, magazines, TV, Instagram, Facebook, LinkedIn, etc. 

○ All Salesforce database contacts, including students and audiences listed above 

○ Students and families 

Your Rights 

● Sharing your image and testimonial is your decision. 

● You have the right to change your mind at any time and revoke your consent. If you inform us in writing that you are revoking your consent, we will not use your personal image or testimonial in future communications. Please understand that we may not be able to withdraw images and stories already published. 

1 For the purpose of this 10,000 Degrees permission form, an “image” is the representation of your likeness in the form of a photo(s), video(s), or illustration(s).

By signing below, I give 10,000 Degrees permission to use my image and name, and I waive any right to royalties or other compensation related to the use of the photographs, video, or testimonial. 

By signing below, I release and hold harmless 10,000 Degrees (including its officers, employees, board members, and agents) and any others who are involved in obtaining, using or publishing such images from and against any claims or actions relating to arising out of the creation, use, distribution, reproduction or publication of any such photographs, video footage, or artistic renderings obtained by 10,000 Degrees. 

I have read this document carefully and understand its contents.

You will receive detailed information on your location, address, and other event details soon. In the meantime, we invite you to reach out to friends and family to ask for pledges. 

If you have questions, please contact Anton Lyons at 925-719-9798 or anton.lyons@10000degrees.org