By submitting this form, I authorize my consent to participate in Safe At Home, and do hereby release Reaching Out Now and Front Royal Cardinals of any liability for injury that may occur while participating as a player or spectator during the event.

I hereby grant Reaching Out Now and the Front Royal Cardinals, the irrevocable, unrestricted right to use, publish, display and distribute materials bearing my name, voice, likeness or any other identifiable representation of myself, my family members including my Safe At Home player/child. These materials may appear in any form, style, color or medium whatsoever (including, without limitation, photographs, video tapes, films sound recordings, software, drawings, prints, broadcast, internet and electronic media). I agree that all material containing any identifiable representation of me (including without limitation, all negatives, plates and masters of any photographs, files, prints or tapes) shall be and remain the sole and exclusive property of Reaching Out Now.

I hereby release and forever discharge Reaching Out Now and the Front Royal Cardinals from any and all liability and damages relating to the use of my name, voice, likeness or any other identifiable representation of me. I hereby waive any right I may have to inspect or approve the finished materials or any part or element thereof that incorporates my name, voice, likeness or any other identifiable representation of myself and my family including my Safe at Home player/child.

I acknowledge that I have fully read and understand this document and that I have had any questions regarding its effects or the meaning of its terms answered to my satisfaction. I certify that I am at least 18 years of age, and if I am not, this form is being submitted by my parent or legal guardian.