Oregon Spinal Cord Injury Connection (OSCI)
ASSUMPTION OF RISK AND WAIVER AND RELEASE OF LIABILITY
*Read Before Signing*
Complete the RSVP Form
Please complete the RSVP form. This form helps us understand how to best meet your needs at the workshop. The information you provide enables us to plan our time and ensure our team can serve every participant who needs repairs or adjustments on their chair.
In consideration of my participation in a wheelchair maintenance workshop provided by Oregon Spinal Cord Injury Connection (“OSCI”), I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that OSCI, its insurers, employees, officers, directors, and agents, shall not be liable for any loss or damage to property, damages arising from personal injuries (including death) sustained by me, on, or about the premises, regardless of whether such injuries result, in whole or in part, from the ordinary negligence of OSCI.
ASSUMPTION OF RISKS: I understand that participating in the wheelchair maintenance workshop involves inherent risks which include but are not limited to: damage to personal property, making unintended alterations to my wheelchair, and physical injuries such scrapes or bruises, muscle strains, muscle pulls, and muscle tears. I agree to comply with all rules imposed by OSCI regarding the use of its facilities and tools. I agree to refrain from using any tools in a manner inconsistent with its intended design and purpose. I agree to be solely responsible for my safety and well-being. I understand that the workshop is limited to instruction on routine maintenance of a wheelchair and should not be used to alter medical positioning. By signing below, I affirm that I know the inherent risks of participating in the workshop, of using tools and equipment on my wheelchair, and understand and appreciate those risks, and agree to assume responsibility for those risks.
WAIVER OF LIABILITY/INDEMNIFICATION: I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me, and I hereby fully and forever release and discharge OSCI, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said equipment and facilities. I expressly agree to indemnify and hold OSCI harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me.
I HAVE READ THE FOREGOING ASSUMPTION OF RISK AND WAIVER AND RELEASE OF LIABILITY. I AM VOLUNTARILY PARTICIPATING IN THE WORKSHOP AND USING THE TOOLS AND FACILITIES AND I AM VOLUNTARILY EXECUTING THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.
Sign Here
[FIRST NAME] [LAST NAME]
Thursday, November 21, 2024
I am of full legal age and have read this assumption of risk and waiver and release of liability and am fully familiar with its contents. By my signature below, I also give my full and unqualified consent to the terms of this assumption of risk and waiver and release of liability on behalf of my minor child.
Sign Here
[FIRST NAME] [LAST NAME]
Thursday, November 21, 2024
Media Release
Oregon Spinal Cord Injury Connection (OSCI) an Oregon nonprofit public benefit corporation tax exempt under Section 501c3 of the Internal Revenue Code, may photograph, videotape or record my voice and use my picture, photograph, silhouette and other reproductions of my physical likeness and sound while I engage in activities sponsored by OSCI.
I have read this Release and agree to the following:
1. OSCI may reproduce, copyright, broadcast, exhibit, and distribute any or all photographs, audiotape or videotape recordings made of me, whether in whole or in part, and whether in their original form or transferred into another medium, for the nonprofit educational or charitable activities of OSCI.
2. I do not have the right to pre-approve my photographs, audiotape, or videotape recordings prior to distribution.
3. I understand that I will not receive compensation, payment, royalty, or other compensation for the use of my photographs, audiotape, or videotape recordings.
4. I understand that OSCI is under no obligation to make any use of my photographs, audiotape, or videotape recordings.
I agree that I will not bring any claims against OSCI, including claims for invasion of privacy, rights of publicity or other similar claims, because OSCI made public images or sounds of me. I release OSCI from all legal claims, known or unknown, which I have or may ever have, arising out of OSCI’s use of my photographs, audiotape, or videotape recordings.
I am of full legal age and have read this release and am fully familiar with its contents. By my signature below, I also give my full and unqualified consent to the terms of this Release on behalf of my minor child.
Sign Here
[FIRST NAME] [LAST NAME]
Thursday, November 21, 2024
As a reminder, this workshop is intended to help participants learn how to maintain a wheelchair. We are not equiped to perform signficant repairs, electrical work, or other major work that may be needed. Our staff of bike mechanics are NOT physical therapists, occupational therapists, or therapy assistants. While we can often help with some minor adjustments we cannot advise on seating or fit for the wheelchair.
We look forward to seeing you at the workshop!