Nico's Promise Model Information & Release Form

Child Information
Thank you for showing interest in being part of Nico's Promise fashion show. The deadline for inclusion is April 5, 2019. Children ages 18 and under are invited to model. Mommies and Daddies with children 3 and under are welcome to participate.
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Permission to Use Photography/Video and Liability Release Form

I grant Nicklaus Children's Hospital Foundation, its representatives and employees the right to take photographs/video of my child and his/her property in connection with the above-identified subject. I authorize Nicklaus Children's Hospital Foundation, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Nico’s Promise Bereavement Services fundraising event may use such photographs of my child with or without their name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

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Nico’s Promise Bereavement Services HOLD HARMLESS AGREEMENT

This is to certify that we, the parents, together with our heirs and legal representatives, release and discharge Nicklaus Children's Health System, Nicklaus Children’s Hospital Foundation, its subsidiaries, employees, agents, directors, officers, affiliated entities and other representatives (“Nicklaus Children’s”), of and from any and all claims, demands, rights and causes of action of whatever kind and nature, arising from and by reason of any and all known and unknown, foreseen and unforeseen causes of action that may be sustained by us or our son/daughter, as a consequence of our participation in the Nico’s Promise Bereavement Services fundraising event.

As a further and additional consideration for such, we agree to indemnify Nicklaus Children's against loss from any and all further claims, demands and actions at law or in equity that may hereafter at any time be made or brought by us or anyone on our behalf for the purpose of enforcing a further claim for damages on account of our and our son/daughter’s participation in the Nico’s Promise Bereavement Services fundraising event. This Hold Harmless will remain valid until and unless we cancel it in writing.

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