Gender *

Allergies? *

Waiver and Release: We, the Participant and/or the Guardian, Release and forever discharge and hold harmless Expanding Boundaries International and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the activities as a participant with Expanding Boundaries International, including claims arising out of negligence. We understand and acknowledge that this Release Discharges Expanding Boundaries International from any liability or claim that we may have against Expanding Boundaries International with respect to bodily injury, personal injury, illness, death, or property damage that may result from the Participant’s involvement in the Expanding Boundaries International activities. *

Photographic Release: I, the undersigned, do hereby grant permission to Expanding Boundaries International Inc. (EBI) and its sponsors and partners to post me and/or my child’s story, photo, or another item, hereinafter referred to as “Materials,” I submit to and for Expanding Boundaries International’s and its partners and sponsors' Website, and social media sites. I hereby release you, your representative, employees, managers, members, officers, parent companies, subsidiaries, and directors, parters and sponsors, from all claims and demands arising out of or in connection with any use of said “Materials”, including, without limitation, all claims for invasion of privacy, infringement of my right of publicity, defamation and any other personal and/or property rights. I acknowledge and agree that no sums whatsoever will be due to me as a result of the use and/or exploitation of the “Materials” or any rights therein. *

Medical Treatment: We, the Participant and the Guardian, hereby Release and forever discharge Expanding Boundaries International and their team from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during the Participant’s activity with the Nonprofit. We give our consent for the Nonprofit to provide, administer, or obtain medical treatment for the Participant. *

The Participant and the Guardian are responsible for the Participant’s own insurance coverage in the event of personal injury or illness as a result of participation in activities with Expanding Boundaries International. In the event of any illness or injury while participating in the event listed in Section A, I hereby consent to whatever x-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care from a licensed physician, surgeon, and/or dentist as deemed necessary for my safety and welfare. It is understood that the resulting expenses will be my responsibility. *