The Sunflower Foundation Suicide Loss Survivor Dinner Invitation Form Please enable JavaScript in your browser to complete this form. - Step 1 of 2Please complete this registration form. Included in your registration is one spaghetti and meatball OR chicken alfredo dinner per person. **Special orders, and specialty drinks are the responsibility of the participant, and will NOT be covered by The Sunflower Foundation. Each individual must register for the event. NO MORE than TWO persons per lost loved one please, as we would like to reach multiple families in the community. There is a maximum of 25 entries accepted. **Please feel free to bring a picture of your lost loved one with you for display if you would like. We would love to celebrate them with you. We look forward to seeing you soon! Name *Email address: *Phone Number:Lost Loved One’s Name:NextThe Sunflower Foundation Loss Survivor’s Dinner Registration *Note: Event may be cancelled and/or rescheduled at any time for any reason. WAIVER RELEASE & CONSENT Safety is our primary concern. Please observe all federal, state and local laws. In consideration of my participation in the above-named event, I HEREBY WAIVE AND RELEASE ANY AND ALL RIGHTS AND CLAIMS OF ANY NATURE, ROUNDED IN WHOLE OR IN PART UPON ANY TYPE OF NEGLIGENCE, that (I) may have against the above party, to include The Sunflower Foundation, The Olive Tree, officers, employees, volunteers and any cooperating entities, their representatives, heirs, executors, administrators, successors, assessors, and/or assigned (the “Released Parties”) arising out of or resulting from any and all injuries or damages of any nature, including death, which (I) may suffer while taking part in the event or any activities connected with the event. I UNDERSTAND THAT BY SIGNING THIS DOCUMENT I AGREE NOT TO SUE any and/or all of the Released Parties in connection with the event. I am voluntarily participating in the event and I expressly agree to sole responsibility for the safety of myself, and to accept the entire risk of any accidents or personal injury, including death, which I might suffer as a result of my participation in the event. I further understand and I assume all risks in participating in the event. The activities of this event may be photographed, live-streamed and/or videotaped. As the undersigned, I agree that my likeness may be used in promotional materials and will hold harmless the “Released Parties” and agree that no monetary or any other consideration will be given for their use. By signing this document, I certify that I have read this document, fully understand it and that I am not relying on any statement or representations of any of the Released Parties. This document shall be binding upon my heirs, executors, administrators, assigns and me. Name *FirstLastEmail *Date / Time *DateTimeBy selecting submit, you have agreed to the waiver. Selecting submit is equal to signing this form. PreviousSubmit
