Le Pit Club LLC 

415-568-6693 | hello@lepitclub.com

lepitclub.com 

For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I, the undersigned, agree as follows: 

1. I agree to be photographed/recorded/videotaped by Le Pit Club and its agents (including Lee Keiper) in connection with my participation in Le Pit Club events.

2. I hereby irrevocably authorize Le Pit Club and its affiliates to copyright, publish, reproduce, exhibit, transmit, broadcast, televise, digitize, display, otherwise use, and permit others to use, (a) my name, image, likeness, and voice, and (b) all photographs, recordings, videotapes, audiovisual materials, writings, statements, and quotations of or by myself (collectively, the “Materials”), in any manner, form, or format whatsoever now or hereinafter created, including on the Internet, and for any purpose, including, but not limited to, advertising or promotion of Le Pit Club its affiliates, or their services, without further consent from or payment to me. 

3. It is understood that all of the Materials, and all films, audiotapes, videotapes, reproductions, media, plates, negatives, photocopies, and electronic and digital copies of the Materials, are the sole property of Le Pit Club. I agree not to contest the rights or authority granted to Le Pit Club hereunder. I hereby forever release and discharge Le Pit Club, its employees, licensees, agents, successors, and assigns from any claims, actions, damages, liabilities, costs, or demands whatsoever arising by reason of defamation, invasion of privacy, right of publicity, copyright infringement, or any other personal or property rights from or related to any use of the Materials. I understand that Le Pit Club is under no obligation to use the Materials. 

4. This document contains the entire agreement between Le Pit Club and the undersigned concerning the subject matter hereof. 

By checking this box, I agree to each and every statement above. 

(Note: If participant is a minor, please register for this event with the child’s name and email address of the participant’s parent or legal guardian)