Event Consent Forms

Note: Each Participant (adults and children) must complete a separate form. For those completing the form using screen readers, please press x to navigate to the checkboxes or f to navigate to the form fields.

General Release of Liability and Hold Harmless Agreement*
- I/my child(ren) agree to assume all risks and to release, hold harmless, and covenant not to sue the National Federation of the Blind or any designated beneficiaries, sponsors, officers, officials, divisions, affiliates, chapters, communities, organizations, friends of the event, and all other government or public entities and all their respective directors, officers, agents, employees, and members for any claim, loss, or liability that I may have arising out of my participation in the event. I / My child will participate in the event facilitated by the National Federation of the Blind of Illinois, and other divisions, affiliates, and Chapters of the National Federation of the Blind. I / My child will adhere to any and all rules and policies of the Program.
MEDIA RELEASE FORM
- I hereby give permission to photograph me and my child) and to use audio and/or video equipment to record my participation in the event of the National Federation of the Blind of Illinois (“NFBI”), and other divisions, affiliates, and chapters of the National Federation of the Blind. I grant permission to use said photos or recordings to promote the programs of the National Federation of the Blind (“NFB”) and the National Federation of the Blind of Illinois, and other divisions, affiliates, and chapters of the National Federation of the Blind. I also understand that print and visual media may be used to distribute information regarding my and/or my child(ren)’s participation in the program. It is understood that this material will be used solely for educational purposes or to promote the programs of the NFB and NFBI.
CODE OF CONDUCT
- I acknowledge that I have read the Code of Conduct of the National Federation of the Blind of Illinois and that I agree to follow its policies, standards, and principles.
National Federation of the Blind Pledge
- I pledge on behalf of myself and my child(ren) to participate actively in the efforts of the National Federation of the Blind to achieve equality, opportunity, and security for the blind; to support the policies and programs of the Federation; and to abide by its Constitution.
Participant's Name*
First Last
Parent / Guardian's Name
if participant is under 18 years of age
First Last