Workshop Release and Waiver

This is a Consent, Release of Rights, Hold Harmless and Authorization Agreement (Agreement”) between the Rolling Robots, Inc., Rolling Robots West LA, LLC. and officers, directors, employees and Designees of each of same (collectively, “Rolling Robots”), and Participant (defined below and referred to as “I”, “Me”, “My” and “Participant”). “Designees” includes those persons or entities managing, contracting, sponsoring, hosting, conducting, evaluating or publicizing (including individuals and entities working with Rolling Robots in print, publication, television, broadcast or video media). As used in this Agreement, “Participant” shall mean any individual, student, mentor, teacher, volunteer, or other person or entity involved in a Rolling Robots activities, workshops, class, or other event (collectively, “Rolling Robots Activity”),.

In consideration of My participation in one or more Rolling Robots activities, I agree to the following:

I hereby grant Rolling Robots the right to photograph, videotape, or otherwise digitally record or collect My name, biography, image, likeness, voice, sounds, plus any other information I provide, associated with My attendance at and/or participation in any Rolling Robots Activity. I further acknowledge that any works made by or for Rolling Robots (“Works”) to be “works made for hire,” under applicable copyright laws, and to the extent I have or may claim any rights in or to such Works, I hereby grant to Rolling Robots any and all such rights, including, without limitation, the right to use or sublicense these Works in any and all media, now known or later discovered or developed, and in all forms and for all purposes, including without limitation, advertising and other promotions for RollingRobot, without any further consideration due to Me or any limitation whatsoever.

I recognize that there may be risks associated with attending and/or participating in a Rolling Robots Activity, including, without limitation, risks inherent in the construction and/or operation of robots, as well as in working with electrical connections, traveling to and from events, and participating in public competitions. These risks include the risk of injury (including without limitation, serious bodily harm and even death) and property damage. Being fully cognizant of the risks in participating in any such event, I hereby fully and willingly assume those risks. Except to the extent due to the gross negligence or willful misconduct of Rolling Robots, to the fullest extent permitted by applicable laws, I HEREBY WAIVE ANY CLAIMS OR CAUSES OF ACTION which I may now have or hereafter arises against Rolling Robots arising out of or connected to My participation in any Rolling Robots Activity and I will indemnify and hold harmless Rolling Robots against any and all claims against any such entity or person resulting from same.

I HEREBY RELEASE Rolling Robots and each of their respective successors, assigns, affiliates, licensees and agents from any and all claims, demands, liabilities, damages, costs and expenses, attorneys' fees, other professional fees and expenses, including, without limitation, any claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever that I may now or hereafter arise against Rolling Robots arising in connection with my participation in any Rolling Robots Activity.

In the event I should sustain any injuries or illness while attending and/or participating in a Rolling Robots Activity, I hereby authorize Rolling Robots to administer, or cause to be administered, such first aid or other treatment and such medications as I may possess as reasonably suggested under the circumstances, including, without limitation, treatment by a physician or hospital of Rolling Robots choice.
This Release shall be binding upon My heirs, personal representatives, and Me. THIS RELEASE SHALL BE GOVERNED BY AND CONSTRUED UNDER THE LAWS OF THE STATE OF CALIFORNIA, WHICH SHALL BE THE VENUE FOR ANY LEGAL ACTION. This Agreement constitutes the entire agreement among the parties hereto with respect to the subject matter hereof and supersedes any and all previous agreements among the parties, whether written or oral, with respect to such subject matter.

I UNDERSTAND THAT THIS FORM INVOLVES A RELEASE OF LEGAL RIGHTS.

  _______ Accept      ______ Decline

Participant Full Name      ____________________

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Parent or Legal Guardian ____________________

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