Register Event Name*Total Event Fundraising Goal*End Date* Date Format: MM slash DD slash YYYY End Time* : HH MM AM PM Ways People Can FundraiseAllow participants of your event to fundraise as a team or individuallyOnly allow participants to fundraise as a teamOnly allow participants to fundraise individuallyYou are not logged in. Register below or login to continue.Name* First Last Email* Phone*Company/OrganizationAddress* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Password* Enter Password Confirm Password I want to create a team to fundraise in my event I want to fundraise with a team I want to create a new teamI want to join a teamYour Team PageTeam NameTeam Fundraising GoalJoin TeamSelect a TeamTest Team 1Your Personal Fundraising PagePersonal Fundraising Goal*Personal Fundraising Goal*Suggested minimum is $300.How did you first hear about The Siloam Sleepout?*NewsSocial MediaEmailSiloam Mission websiteWord of mouth I am a past participant of the CEO Sleepout I am 18 years of age or older*YesAll participants of the 2019 Siloam Sleepout must be 18 years of age or older. For more information on this event policy please email email@example.com SILOAM SLEEPOUT RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT. READ CAREFULLY. IN CONSIDERATION of the acceptance of my application and the granting of permission for me to participate as an entrant in the 2019 Siloam Sleepout and any or all of its associated events (the “Siloam Sleepout”), I, for myself and all of my heirs, executors, administrators, personal representatives, successors and assigns (collectively referred to as the “RELEASORS”) WAIVE, RELEASE, FOREVER DISCHARGE AND AGREE NOT TO SUE Siloam Mission and all/or other organizers, associations, sanctioning bodies and sponsoring companies, and all of their respective past, present and future representatives, parent companies, subsidiaries, divisions, affiliates, controlling persons, suppliers, distributors, contractors, agents, officials, assigns, servants, professional advisors and insurers, and all of their officers, directors, employees, shareholders, predecessors, successors in interest, assigns, heirs, executors, administrators or personal representatives, as may be applicable (collectively referred to as the “RELEASEES”), from any and all causes of action, actions, suits, claims and demands for damages, liability, indemnity, expenses, interest, fees and costs, including legal fees and disbursements, whether at law or in equity or under any statute, in respect of death, injury, loss or damage of every nature and kind however occurring or caused, whether anticipated or unanticipated, resulting from, arising out of or connected directly or indirectly with my participation in the Siloam Sleepout, whether as a spectator, participant, or otherwise, whether such death, injury, loss or damage occurs prior to, during or subsequent to the Siloam Sleepout, and despite that any such death, injury, loss or damage may have been caused by, contributed to or occasioned by the negligence of any of the RELEASEES. I WILL INDEMNIFY AND SAVE AND HOLD HARMLESS THE RELEASEES from and against any and all liabilities, losses, damages, interest, costs and expenses incurred by me and/or the other RELEASORS arising out of, as a result of or in any way connected with my attendance at and/or participation in the Siloam Sleepout, regardless of whether such liability, losses, damages or costs were caused by, contributed to or occasioned by the negligence of any of the RELEASEES or otherwise. I WILL NOT TO MAKE ANY CLAIM, take any proceeding or commence or maintain any action in connection with the matters which are released and discharged above against any other person or corporation who might assert a claim over or against any of the RELEASEES, or who might claim contribution or indemnity from the RELEASEES. I ACCEPT AND ASSUME FULL RESPONSIBILITY for any and all risks of bodily injury, death or property damage arising out of or related to the Siloam Sleepout, whether caused by, contributed to or occasioned by the negligence of the RELEASEES or otherwise. I agree that at all times prior to, during or subsequent to the Siloam Sleepout, I will be solely responsible for the safety of my person and my property. I AGREE that this Release, Waiver of Liability and Indemnity Agreement (this “Agreement”) extends to cover all acts of negligence by the RELEASEES and is intended to be as broad and inclusive as is permitted by the laws of the province in which the Siloam Sleepout is conducted. If any portion or portions of this Agreement may be held by a court of competent jurisdiction to conflict with any federal, provincial or local law, and as a result such portion or portions are declared to be invalid and of no force and effect in such jurisdiction, then all remaining provisions of this Agreement will otherwise remain in full force and effect and will be construed as if such invalid portion or portions had not been included in this Agreement. I WILL NOT CONSUME, BE IN POSSESSION OF, OR BE UNDER THE INFLUENCE OF DRUGS OR ALCOHOL DURING MY PARTICAPTION OF THE SILOAM SLEEPOUT, AND UNDERSTAND THAT I MAY BE ASKED TO LEAVE IF I AM FOUND TO BE CONSUMING, IN POSESSION OF, OR UNDER THE INFLUENCE OF DRUGS OR ALCOHOL DURING ANY PORTION OF THE EVENT. I consent to the collection, use and disclosure by any of the RELEASEES of my name, photograph, image, video image(s)/actions and/or other likeness in any publications or advertising, in any form or media, including but not limited to printed materials, the Internet (including social media) and broadcasts regarding the event (collectively, the “Materials”). I release the RELEASEES from any and all liability, actions, causes of action, claims, costs and payments for damages, loss or injury, however occurring as a result of the use of my name, photograph, image, video image(s)/actions and/or other likeness in the Materials. By submitting this registration form to Siloam Mission, I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS AGREEMENT, fully understand its terms without reservation, understand that I have given up substantial rights by signing it, and have signed it freely and voluntarily without any inducement, assurance or guarantee being made to me and intend my signature to be a complete, final and unconditional release of all liability to the greatest extent allowed by law.I have read the Sleepout Waiver and agree to its terms*I agreeWhile Siloam Mission will make every best effort to ensure to accuracy and credibility of events on this site, it assumes no responsibility for the content and/or activities of such. Spending of funds is confined to programs and projects approved by the executive of Siloam Mission.