EVENT REGISTRATION / RELEASE FORM

I have read and understand the information regarding this event and understand that I am attending and participating in this event at my own risk. I agree to comply with the rules and directions of event personnel. I hereby consent that the use of my name and image may be captured used in the media and for general promotional and social purposes involving Central Florida Association of Physicians from the Indian Subcontinent Inc, a Florida Not for Profit Corporation (hereinafter "CAPI"). On my behalf and on behalf of any attendees with me, I hereby acknowledge this waiver, release and indemnity discharge all persons, corporations, associations and bodies involved or otherwise engaged in promoting or staging the event and their servants, agents, representatives, officers and employees whether or not the loss, injury or damage is attributed to the act or neglect of any or more of them.

Minors: In the event a Minor is accompanying me, I understand that a Minor is required to be familiar with and to abide by the Rules and Regulations established for the Event, and any safety regulations established for the benefit of all participants. I, or another adult that I designate, accept sole responsibility for the conduct and actions of the Minor while he or she is attending the Event. I, or another adult that I designate, am/is responsible for the Minor's safety and well being at all times and under all circumstances while at the Event. On behalf of the Minor, I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: CAPI, its members, officers, directors, partners, shareholders, members, agents, employees and volunteers (Individually and Collectively, the "Released Parties" or "Event Organizers"), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court costs and reasonable attorneys fees) of any kind or nature ("Liability") which may arise out of, result from, or relate in any way to the Minor's attendance at the Event, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released Parties. I further agree that if, despite this Agreement, the Minor, or anyone on the Minor's behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities which any may be incurred as the result of such claim.

I hereby warrant that I am of legal age and authorized to enter into this Release on behalf of the Minor, that I have read this Agreement carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal rights by signing it (including the rights of the Minor, the Minor's parents/legal guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns), acknowledge that I have signed this Agreement without any inducement, assurance or guarantee, and intend for my attendance at the event and submission of acceptance to serve as confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this Release.