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By typing in my name below I confirm that, I, the parent or legal guardian of the aforementioned minor child(ren), have applied for participation in the Heroes Circle program(s). I give my consent and approval to his/her participation in the above-selected program and activities provided by, or through, the Heroes Circle I assume all risks and hazards incident to the conduct of the program and such activities, and for any martial arts instruction/activity he/she will receive or participate in connection therewith. I confirm that myself and the aforementioned child(ren) hereby agree to release and absolve, indemnify, and hold harmless, and do by this document release, absolve, indemnify and hold harmless Kids Kicking Cancer Inc. (Heroes Circle is a division of Kids Kicking Cancer) and any and all of its subsidiaries, affiliates, officers, directors, employees, agents, supervisors, organizers, coaches, sponsors, and volunteers (collectively, the “Released Parties”) of and from any and all liability for any injury to my/or aforementioned child. I waive all claims for myself and the aforementioned child(ren) of any kind against any and all of the Released Parties.

I grant full permission to Kids Kicking Cancer, their agents, representatives and appointees to photograph and/or videotape my child(ren) and to use, publish and release for publication such photos relating to the Kids Kicking Cancer program.  May include Kids Kicking Cancer website and social media.  The name(s) of my child(ren) may be used in connection with the above-stated photographs with the understanding that there will be no exploitation of my child(ren) and that any photographs and/or videos will conform to good standards of taste.