Pro Bowl Events and Entertainment Medical Information

Name ______

Home Address ______City/State/Zip ______

Home Telephone ______Date of Birth ______

Emergency contact ______Day Phone ______

Health Insurance Company ______Policy Number ______

Family Doctor ______Doctor’s Phone ______

Have you had any serious illness, surgery or injury? If yes, please describe and give date(s): ______

Do you have any medical problems that may interfere with this event or performance? ______

If yes, describe the problem or limitations______

Do you have medication for this, with you? If yes, please describe ______

Medical Treatment and Authorization and Liability Release I, will be a participant in various activities, events, rehearsals, and performances at the Football Festival associated with the 2013 in (“the Event”). I understand that my participation in the Event involves certain risks of physical injury associated with, arising out of and inherent to my performance. I am voluntarily participating in the Event with knowledge of the danger involved and agree to accept all risks of participation.

In return for being allowed to participate in the Event, I do hereby, for myself, my heirs, administrators, executors, guardians, assigns, representatives, and next of kin, forever waive, release, discharge, and covenant not to sue the , NFL Ventures, L.P., NFL Ventures, Inc., the League’s thirty-two member professional football clubs, NFL Properties LLC, NFL Productions LLC, NFL Enterprises LLC, NFL International LLC and each of their affiliates, subsidiaries, sub-contractors, officers, directors, shareholders, agents, representatives, employees, sponsors and licensees (collectively, the "NFL Entities"), e2k Events and Entertainment, The University of Hawaii, , the City and County of and each of their officers, directors, employees, sub-contractors, sponsors, agents and affiliates (along with the NFL Entities, collectively, the "Producers") from all present and future claims, including any claims of negligence, that may be made by me, my family, estate, heirs, or assigns for property damage, personal injury, or wrongful death arising as a result of my participation in the Event or any related activities, wherever, whenever, or however the same may occur.

I hereby agree to release the Producers and hold them harmless of all liability, and hereby acknowledge that I knowingly and voluntarily assume full responsibility for all risks of physical injury arising out of my participation at the Event.

I am aware that this is a release of liability and acknowledgment of my voluntary and knowing assumption of risk of injury. I have signed this document voluntarily and on my own free will in exchange for the privilege of participation in the Football Festival.

I hereby authorize the Producers or their agents to act in my behalf to provide emergency medical treatment in the event of injury or illness. I further release the Producers of all claims arising out of any such medical treatment provided.

If I am a minor, my parent and/or legal guardian has signed this document releasing the Producers from any and all such liability described above and has acknowledged that I am knowingly and voluntarily assuming all risk of injury inherent to this activity.

Photograph, Television, Tape, Movie and/or Sound Recording Authorization and Release I hereby authorize and consent that the NFL Entities and its designees may use (unless prohibited by law), my name, city and state of residence, photograph, likeness and/or oral of written statements made by me for advertising, trade and/or any other purposes in any media now or hereafter known throughout the world in perpetuity, without further compensation, permission or notification.

I hereby waive all claims for any compensation for such use or for damages. I hereby waive any right that I may have to inspect and/or approve the finished product or the advertising copy that may be used in connection therewith or the use to which it may be applied.

I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Event is taking place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in New York, New York.

I have read this form and understand that by signing this form, I am giving up legal rights and remedies.

______Signature Date

(If Participant is under 18 years of age, the parent(s) or guardian(s) must execute in addition to the above, the following waiver:) Parent/Legal Guardian if Participant is Under Age 18 I am the parent or legal guardian of the Event participant. I am of legal age and am freely signing this agreement on behalf of the Event participant. I have read this form and understand that by signing this form, I am giving up legal rights and remedies on behalf of myself, the Event participant and his/her family, estate, heirs, and/or assigns.

Signed:______

Relationship to Minor:______