Waiver of Liability and Photo Release

On behalf of the entire group participating in the 2012 Jerry Stautberg Memorial Car Show, I assume all risk of bodily injury, property damage, and personal damage that may occur by participating in the 2012 Jerry Stautberg Memorial Car Show and, for myself/ourselves, their heirs, executors, and administrators, do hereby forever waive and release any and all claims against and agree to hold harmless the Jerry Stautberg Memorial Car Show. Its committee, sponsors and volunteers, and the City of Cheviot with their respective officers, employees, agents, representatives, volunteers, successors or assigns any kid from any and all claims which may be made for any cause whatsoever arising as a result of participation. 

Further, I hereby consent to allow my picture or likeness to appear in any official document, news release, sponsor advertisement and/or television and radio coverage of the events within or as part of the 2012 Jerry Stautberg Memorial Car Show, and grant permission to use and/or publish photographic portraits, or pictures, video tape or film of me in which I may be included in whole, part, composite or reproductions thereof in black and white and/or color or otherwise made through any media now known, for art, advertising trade or any other similar lawful purposes whatsoever, including the publicity and promotion of this event itself, excluding commercial use of or by marketing sponsors.



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Print Name_________________________________________________________________



Date ______/_______/________