Liability Waiver for Free to Be Me retreat

VOLUNTARY PARTICIPATION
1. I acknowledge that I have voluntarily applied to participate in the Awake Youth Project, Brooklyn Zen Center (Brooklyn Zen Center) retreat for teenagers and/or young adults aged 13-19 on April 29th and 30th, 2016, entitled Free to Be Me, referred to below as "this event", at the premises of Brooklyn Zen Center, hereafter referred to as "facility", in the city of Brooklyn, NY. I acknowledge that all information on this application is accurate and complete - including all medical information. 

ASSUMPTION OF RISK
2. I am aware that participating in this event may involve strenuous physical activities such as work meditation, yoga, or movement classes, as well as risks associated with being a pedestrian in the urban setting including contact with public transportation and vehicular traffic. I am also aware that this is an intensive meditation retreat and that participants in such retreats may experience intense and unusual psychological, spiritual, and/or physical states of mind and body arising from the meditation and associated retreat activities. I am voluntarily participating in these activities with full knowledge of the risks involved, and hereby agree to accept any and all risks of harm that may result from these activities. 

RELEASE
3. As consideration for being  permitted by Brooklyn Zen Center to participate in these activities and use their facilities, I hereby agree that I, my parents, my guardians, my assignees, heirs, distributees, and legal representatives will not make a claim against, sue or attach the property of Brooklyn Zen Center facility, their affiliates, employees, agents or volunteers or any of their affiliated organizations for injury or damage resulting from acts, howsoever caused, by any employee, agent, or contractor of Brooklyn Zen Center, or any of their affiliated organizations, as a result of my participation in this event, except when an employee, agent, or contractor of facility, or any of their affiliated organizations exhibits gross negligence or intentionally acts in a manner likely to lead to my being harmed. I hereby release Brooklyn Zen Center and any of their affiliated organizations from all actions, claims or demands that I, my parents, my assigns, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my participation in this event, except when an employee, agent, or contractor of Brooklyn Zen Center or any of their affiliated organizations exhibits gross negligence or intentionally acts in a manner likely to lead to my being harmed.

I acknowledge that there will be Rules and Guidelines provided for what is acceptable during this event in order to ensure that I stay safe and healthy while in the care of Brooklyn Zen Center.  If I choose to not follow the guidelines, I acknowledge that Brooklyn Zen Center is no longer responsible for my safety and health. 

I acknowledge that I and my teen are responsible for ensuring their timely and safe arrival and departure to/from the Brooklyn Zen Center for this event, and I hereby agree that Brooklyn Zen Center will not be in any way held responsible to provide transportation to and from the retreat. 

KNOWING AND VOLUNTARY EXECUTION
4. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract among myself, facility and/or their affiliated organizations, and sign it of my own free will.

VIDEO/AUDIO
5. I do hereby confirm the consent given you with respect to your photographing or recording me or my child in connection with the Awake Youth Project Teen Retreat. I hereby grant to you the right to use all the videos, photographs, and audio recordings which you may make of me or my child, and the right to use my name and/or child’s name or likeness in or in connection with publicly displaying the retreat or any other use of such video, picture, or audio recording.

Teen Signature *
Teen Signature
Parent Signature *
Parent Signature
Date *
Date