2020 Participant Waiver Participant Name* First Last Email* Phone*Retreat Location*Blue Ridge (Not Applicable)Key West (Not Applicable)Emerald IsleOrange BeachManisteeGrand HavenOak IslandMyrtle BeachCentral CoastNew Smyrna BeachAssumption of Risk: I (We) hereby acknowledge the activities associated with the original Little Pink programming are no longer a part of our vacation experience. Little Pink Houses of Hope does not own, operate, or control the facilities where my family will be housed. As a consequence, the below signed hereby acknowledges that he/she does hereby assume all risk of any injury, illness, harm or damage of any type that may occur in the course of his/her own personal or his/her child’s course of the week and release Little Pink Houses of Hope and it’s Board, Officers, Venue, Staff, and Volunteers from any liability or responsibility whatsoever.I (We) agree or disagree with the terms of the Assumption of Risk:* Agree Disagree Medical Treatment: I (We) release LPHOH staff and board of directors retreat leader(s) of any medical indemnity. I understand that I (We) will have to provide or arrange related transportation for myself or child due to injury, illness, or medical emergency. I (We) agree or disagree with the terms of the Medical Treatment:* Agree Disagree Permission of Media I (We) grant permission for the named to participate in any audio-visual, photo, interview, or multi-media event that may take place by Little Pink House of Hope and I (we) release everyone involved from liability or claims in association with said coverage. I (We) agree or disagree with the terms of the Permission of Media:* Agree Disagree Media Release I (We) grant permission for any photos, audio-visual footage, interviews both recorded and printed of the named individual(s), to be used for publication in any multi-media or advertising format, such as brochures, websites, television, public service announcements, ads and publications with the express purpose of marketing and promoting Little Pink Houses of Hope.I (We) agree or disagree with the terms of the Media Release:* Agree Disagree Social Media Group Sharing Release I (We) grant permission for any photos, audio-visual footage, interviews both recorded and printed of the named individual(s), to be shared on social media by Little Pink representatives or by other retreat participants.I (We) agree or disagree with the terms of the Social Media Group Sharing Release:* Agree Disagree Family Contact Information Release Little Pink Houses of Hope (LPHOH) shares family contact information within the confines of the Little Pink App to allow families to contact each other directly. The App also includes schedule information to be used throughout the week. The LPHOH roster is password protected and on the secure portion of the LPHOH App. Only participants in your current retreat location have access to this portion of the App with a unique password. LPHOH follows technology recommendations to keep this data safe and secure and does NOT share this information with any third party entity and does NOT sell personal data. Choose all that apply:* I (We) grant permission for my family contact information (phone number, address, email address) to be shared on the Little Pink App. I (We) agree with the terms of the Personal Contact information Sharing Release I (We) disagree with the terms of the Personal Contact information Sharing Release Participant: I voluntarily sign this waiver in favor of Little Pink Houses of Hope, Landlord/Property Donor/Owner in consideration for this retreat opportunity. I acknowledge that I have carefully read each section of this Waiver and understand its contents. I am aware that by signing this, I am waiving certain legal rights, including the right to sue Little Pink Houses of Hope, the Landlord/Property Donor/Owner for any reason. Please enter your first and last name as your formal signature.Participant Signature*