EVENT WAIVER AND RELEASE
FOR
Power Boost Live 2012
12-13 October 2012
In consideration for being permitted to participate in the Skip Winter Conference and
related activities (the "Event") conducted or organized by Ganas Consulting LLC (the
"Organizer"), I, Sergio Romano (the "Participant"), hereby agree as follows:
I ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN
THE EVENT, including by way of example and not limitation, any risks that may arise
from negligence or carelessness on the part of the persons or entities being
released, from dangerous or defective equipment or property owned, maintained, or
controlled by them, or because of their possible liability without fault.
I certify that I have not been advised to not participate by a qualified medical
professional. Furthermore, I certify that there are no health-related reasons or
problems that preclude my participation in the Event.
I acknowledge that this Accident Waiver and Release of Liability Form will be used
by the Organizer, and that it will govern my actions and responsibilities in the Event.
I hereby take action for myself, my executors, administrators, heirs, next of kin,
successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE the Organizer and/or its directors,
officers, employees, volunteers, representatives, and agents, Event sponsors, and
Event volunteers from any and all liability, including but not limited to, liability arising
from the negligence or fault of the entities or persons released, for my death,
disability, personal injury, property damage, property theft, or actions of any kind
which may hereafter occur to me including my traveling to and from this event;
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or
persons mentioned in this document from any and all liabilities or claims made as a
result of participation in this activity or event, whether caused by the negligence of
release or otherwise.
I acknowledge that the Organizer and its directors, officers, volunteers,
representatives, and agents are NOT responsible for the errors, omissions, acts, or
failures to act of any party or entity conducting a specific event or activity on behalf of
the Organizer.
I hereby consent to receive medical treatment that may be deemed advisable in the
event of injury, accident, and/or illness during the Event.
I understand that at this event Event, I may be photographed and recorded on audio

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and video. I agree to allow my photo, video, or film likeness to be used for any
legitimate purpose by the Organizer and assigns.
This Accident Waiver and Release of Liability shall be construed broadly to provide a
release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE CAREFULLY READ THIS DOCUMENT AND FULLY
UNDERSTAND THAT IT IS A RELEASE OF ALL LIABILITY AND A WAIVER OF
ANY RIGHT THAT I MAY HAVE ON BEHALF OF MYSELF AND/OR ANY PERSON
ACTING ON MY BEHALF TO BRING LEGAL ACTION OR ASSERT A CLAIM FOR
INJURY OR LOSS OF ANY KIND AGAINST THE ORGANIZER OR ANY PARTY
ACTING ON ITS BEHALF.
Dated: __ / __ / ____
Participant

_________________________
Sergio Romano

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CONGRATULATIONS! YOU ARE THE PROUD OWNER OF AN AUTHENTIC
POWERBOOST. THIS AGREEMENT WAS SIGNED USING OURDEAL EVENTS.
To ensure the integrity of this agreement, all contract data has been encrypted
and secured with a unique identification key to prevent alteration or removal.

AGREEMENT:

PowerBoost
SIGNED BY:

Sergio Romano on 12 Sep 2012 04:27 AM
(127.0.0.1)

Agreement Started
Signed

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12 Sep 2012 04:27 AM
12 Sep 2012 04:27 AM