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Health Awareness Proven, Possible, and Powerful!

2023 NCHI Walk/Tournament

The purpose of the National Community Health Initiative (NCHI) is to promote education and awareness regarding diseases and health conditions that disproportionately impact communities of color and to eradicate the associated health disparities. Additionally, the NCHI aims to improve the lives of the AEAONMS family and the communities in which we are residents through health promotion, outreach, and advocacy.

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Donate via the following: 

RELEASE OF LIABILITY

IN CONSIDERATION OF the risk of injury that exists while participating in the NCHI Walk and/or Kickball Tournament (hereinafter the "Activity"); and

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IN CONSIDERATION OF my desire to participate in said Activity and being given the right to participate in same;

I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity; and

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I HEREBY release and forever discharge Palestine Temple #18 and Palestine Court #49 located at 164 New Shiloh Ave Mobile, AL 36693, the Ancient Egyptian Arabic Order Nobles Mystic Shrine Inc., their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns (collectively "Releases"), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned activity.

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I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH.

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I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.

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I FURTHER AGREE to indemnify, defend and hold harmless the Releases against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs.

 

I FURTHER ACKNOWLEDGE that Releases are not responsible for errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity on behalf of Releases. If I should require medical care or treatment, I authorize Palestine Temple #18 and Palestine Court #49 to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred because of such treatment. I am aware and understand that I should carry my own health insurance.

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I FURTHER ACKNOWLEDGE that this Activity may involve a test of a person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Activity unless I am medically able and properly trained, and I agree to abide by the decision of Palestine Temple #18 and Palestine Court #49 official or agent, regarding my approval to participate in the Activity.

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I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE PALESTINE TEMPLE #18 AND PALESTINE COURT #49, THE ANCIENT EGYPTIAN ARABIC ORDER NOBLES MYSTIC SHRINE INC., ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS. FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST FOR PERSONAL INJURY OR PROPERTY DAMAGE.

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To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of Ancient Egyptian Arabic Order Nobles Mystic Shrine Inc. its agents, and employees.

I agree that this Release shall be governed for all purposes by Alabama law, without regard to any conflict of law principles. This Release supersedes all previous oral or written promises or other agreements.

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If any damage to equipment or facilities occurs because of me or my family's or my agent's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.

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THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.

Thank you for your submission!

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