Family Retreat 2021 Registration

Main Registrant


Additional Family Member 1


Additional Family Member 2


Additional Family Member 3


Additional Family Member 4


Additional Family Member 5



Photo and Video Waiver

By submitting this form and participating in online and/or in person activities as part of the SUDC Foundation's 2021 Family Retreat, I hereby grant permission to the SUDC Foundation and its representatives to take photographs and video recordings of myself and any other family attendees I have registered in this form, including legally dependent minors, and to make recordings inclusive of our recorded voices and names at the SUDC Foundation’s 2021 Family Retreat.


I further grant to the producers, the SUDC Foundation, its servants, agents or employees, and their representatives the right to reproduce, use, exhibit, display, broadcast, distribute and create derivative works of these images and recordings in any media now known or later developed, which may include my name or the names of anyone else listed in this consent. I acknowledge that the SUDC Foundation owns all rights to the images and records. I hereby waive any right to inspect or approve the use of the images or recordings or of any written copy. I further waive all moral rights. I also waive any right to royalties or other compensation arising from or related to the use of the images, recordings, or materials. I hereby release, defend, indemnify and hold harmless the producers, the SUDC Foundation, it servants, agents or employees, from and against any claims, damages or liability arising from or related to the user of the images, recordings or materials, including but not limited to claims of defamation, invasion of privacy, or rights of publicity or copyright infringement, or any misuse, distortion, blurring, alteration, optical illusion or use in composite form that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution. I am 18 years of age or older and I am competent to contract in my own name. I have read this document before signing below, and I fully understand the contents, meaning and impact of this consent, waiver, indemnity and release. This consent, waiver, indemnity and release is binding on me and any minors I may have included in this release, my heirs, executors, administrators and assigns.