JUNE 4 BLACK-OWNED BUSINESS VIRTUAL EVENT - REGISTRATION CONFIRMATION

Thank you for registering for our June 4 ShopBlackCT.com Virtual Event!

This event is for businesses that are listed on ShopBlackCT.com. CLICK HERE IF YOUR BUSINESS IS NOT YET LISTED ON THIS SITE.

PLEASE COMPLETE THE FORM BELOW TO CONFIRM YOUR TIME SLOT. THIS FORM MUST BE SUBMITTED BY 4/30/21 OR YOUR SPOT MAY BE GIVEN TO A BUSINESS ON THE WAIT LIST.

    RELEASE & WAIVER OF LIABILITY

    This Release and Waiver of Liability (the “release”) executed by me (“I”, “my”, or “Attendee”) releases ShopBlackCT.com, as well as their representatives and volunteers (hereinafter known as “Released Parties”) relating to the ShopBlackCT.com Virtual FB Live event organized by ShopBlackCT.com (“Event”). I understand that by registering for and attending the Event, I am agreeing to the terms of this agreement.

    ​1. Rules and Regulations
    I will abide by the rules, regulations and instructions of ShopBlackCT.com and the Released Parties relating to the Event.

    2. Assumption of Risk
    I hereby expressly assume risk of injury or harm from any activities coinciding with ShopBlackCT.com's Virtual Event.

    3. Limitation of Liability
    I hereby forever waive, release, covenant not to sue and discharge the Released Parties from any and all claims resulting from the inherent risks or the ordinary negligence of the Released Parties that I may have arising out of my attendance the Event.

    4. Indemnification
    I hereby agree to hold harmless, defend and indemnify ShopBlackCT.com (and the other Released Parties) from any and all claims made by me arising from injury or loss due to my attendance of the Event. This applies both to claims arising from the inherent risks of the Event or the ordinary negligence of ShopBlackCT.com or any Released Parties. I further agree to hold harmless, defend, and indemnify ShopBlackCT.com and the other Released Parties against any and all claims.

    5. Photography and Video Release
    I irrevocably grant unlimited permission to ShopBlackCT.com to use, reproduce, disseminate and distribute any and all photographs, images, video recordings, motion pictures, recordings, or any other depiction of any kind of my attendance at the Event or related activity in perpetuity and I understand that I will not be entitled to any compensation in connection therewith. I further hereby irrevocably and absolutely grant permission to ShopBlackCT.com to film, videotape and record me in the Event and subsequently to telecast, distribute and otherwise utilize the same in whatever manner ShopBlackCT.com shall deem appropriate. Such permission shall include granting the unlimited and irrevocable rights to ShopBlackCT.com, without compensation of any kind to me, to use, reproduce or broadcast, my name, nickname, image, likeness, voice and photograph, in connection with the Event. I acknowledge that ShopBlackCT.com  shall have unlimited right throughout the world to copyright, use, reuse, publish, republish, broadcast and otherwise distribute depictions of or information about me and all or any portion of the Event in which I may appear on any and all radio, network, cable and local television programs and in any print materials and in any other format or media (including electronic media) now known or hereafter devised in perpetuity and without compensation to me.

    6. Personal Information
    I authorize the Released Parties to collect and use personal information on this form for the purpose of management and administration of the Event. 

    7. Severability
    I understand and agree that this agreement is intended to be as broad and inclusive as is permitted by law and that if any provision shall be found to be unlawful, void or for any reason unenforceable, that provision shall be severed from this agreement without affecting the validity and enforceability of any remaining provisions.

    Acknowledgment of Understanding:
    I have read this agreement fully understand its terms. I understand that I am giving up substantial rights, including my right to sue. I further acknowledge that I am signing this agreement freely and voluntarily and intend my signature to be a complete and unconditional release of all rights to photographs of myself, all liability of ShopBlackCT.com (and other Released Parties) or the inherent risks of the activity, to the greatest extent allowed by law.

    I HAVE CAREFULLY READ AND FULLY UNDERSTAND THIS WAIVER. 
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