Consent and Release Form

Informed Consent, Release, Indemnity and Media Authorisation Form 1.

Participant’s Details Full Name (in block letters): Address (in block letters): Name of school/ institution/organisation: Passport No. (if any): Email address: Date of birth:

2.

Citizenship: Phone No.:

Participant’s Consent In consideration of the Organisers’ (as defined below) acceptance of the person (identified in Section 1 above) (the “Participant”) for the Events (as defined below), the Participant agrees, confirms and undertakes with the Organisers (as defined below) as follows:-

2.1 The Participant who participates in any of the events (the “Events”) organised by World Robot Olympiad (“WRO”) and other parties (organizers, sponsor etc.) designated and approved by WRO (the “Partner”) (WRO and the Partner are collectively, the “Organisers”), agrees that while the Organisers shall endeavour to provide a reasonably safe environment in which the Events are carried out, there may nevertheless be risks associated with the Events. Accordingly, the Participant agrees that his or her participation in the Events shall be done entirely at the Participant’s own risk and the Participant shall be deemed to have understood the risks and conditions associated with the Events. The Participant further agree not to hold liable, the Organisers, their respective subsidiaries, employees and agents, to the extent permitted by law, for any death, personal injury, loss or damage arising out of the Participant’s participation in the Events whether in contract, tort (including negligence or breach of statutory duty) or otherwise. 2.2 The Participant hereby grants to the Organiser (WRO and Partners) the right to photograph and/or videotape the Participant during his or her participation in any Event. The Participant further grants to the Organisers a world-wide, royalty-free and perpetual right to use the images and videos of the Participant’s likeness, voice and sounds during his/her participation, and to license such right to reuse such images and videos of his/her participation, and his/her name, likeness and biography, in any and all media for any purpose, including advertising and other promotions, without compensation to the Participant or his/her parent or guardian. Each of such images and videos shall be a work for hire and the Organisers shall be deemed the owners of any copyright and/or trademark rights therein. The Organisers may use the Participant’s information for their programme and promotions. 2.3 The Participant agrees, confirms and undertakes with the Organisers as follows:(a) the Participant consents to the collection, use and disclosure of his/her personal data for the purposes of facilitating his/her participation in the Events and for the uses set out in Section 2.2 above; and (b) the Participant shall indemnify the Organisers for (i) any damage to property, loss, expense or cost suffered by the Organisers; and (ii) against any claim made by any third party against the Page 1of 2

Organisers and from any expense or cost incurred by the Organisers in the event they are held liable for damages in respect of such claim by reason of or arising out of any injury, death, damage to property, loss, expense or cost occurring to any person which is caused by or as a result of any act or omission of the Participant 2.4 I have read and accept the above terms and conditions.

Signature (Participant) 3.

Date

Parental / Guardian Consent (for underaged Participants/Minors) In consideration of the Organisers accepting the Participant for the Events, I, __________________________________________________ (Full Name of Parent/Guardian), ____________________ (Passport No.), who is a parent / guardian (delete where appropriate) of my child / ward (delete where appropriate), having read and understood the conditions herein hereby confirm, agree and undertake with the Organisers as follows:(a) I give consent to the Participant to participate in the Events; (b) I grant, consent and agree with the declarations and undertakings made by the Participant at Section 2 above; and (c) I shall indemnify the Organisers for (i) any damage to property, loss, expense or cost suffered by the Organisers; and (ii) against any claim made by any third party against the Organisers and from any expense or cost incurred by the Orgnanisers in the event they are held liable for damages in respect of such claim by reason of or arising out of any injury, death, damage to property, loss, expense or cost occurring to any person which is caused by or as a result of any act or omission of the Participant. Contact Number: ____________________ Email address: ______________________________

Signature (Parent / Guardian)

Date

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