Experience Agreement

Please initial items 2, 3, 4, 5 and 20 where indicated, below:

1. Granting of Experience. Forward Foundation (“FF”) shall assist with the Experience requests for the person identified below (“Recipient”) and Recipient’s immediate family members or caregiver – such as a spouse, significant other, caregiver, mother, father, and/or dependent children who live in the home and are under the age of 18, subject to the terms and conditions set forth in this agreement. FF reserves the right in its sole and absolute discretion, to decide if an Experience will be granted and on what terms. FF shall have no obligation to fulfill any Experiences hereunder if it elects to terminate or abandon such Experiences pursuant to section 10 below.

2. Permission to disclose medical condition. The Recipient grants FF the right to disclose the nature of his/her medical condition to the extent necessary in the fulfillment of the Experience. Furthermore, the Recipient grants FF permission to obtain medical information about the recipient which FF may feel necessary for fulfillment of the Experience and authorize all physicians and medical care providers to provide FF with all medical information. _____________[initial here]

3. Waiver. The Recipient and all participants hereby waive any and all rights he or she may have or may hereafter acquire against FF, its officers, directors, agents, and employees arising out of any injury, damages, or losses suffered by the Recipient, and all participants, arising out of or in any way related to FF preparation, execution or fulfillment of the Experience, regardless of whether such loss or harm is caused by the active, passive or gross negligence of FF or any other person. _____________[initial here]

4. Release. Recipient, and all participants, together, and each of them individually, does hereby forever release and remise FF, its officers, directors, agents, and employees from any and all claims, lawsuits, damages, or losses arising out of or in any way related to FF preparation, execution or fulfillment of the Experience, any injury, damages, or losses suffered by Recipient or participants, or any of them of whatever nature, and of whatever extent, regardless of whether such loss or damage is caused by the active, passive or gross negligence of FF or any other person. _____________[initial here]

5. Indemnity. Recipient, and all participants, together and each of them individually, hereby agree to indemnify and hold harmless FF, its officers, directors, agents, and employees of and from any and all losses suffered by FF, its officers, directors, agents, and employees as the result of any claim, lawsuit, or action arising out of or relating in any manner to FF’s preparation, execution and fulfillment of the Experience, or due to a breach by Recipient, or any participants, of the representations, warranties or covenants contained in this agreement. Said hold harmless and indemnity includes, but is not limited to, reasonable attorney’s fees and costs incurred by FF, it officers, directors, agents, and employees in retaining attorneys of FF’s choice to defend any and all such claims, lawsuits, and actions. _____________[initial here]

6. Relatives/Friends. No person may accompany the Recipient during any portion of the Experience fulfillment, unless specifically agreed to in writing between FF and Experience Recipient.

7. Experience expenses. The expenses FF has agreed to pay for are those foreseeable and directly related to the fulfillment of the Experience. Experience Recipient, relatives or friends, together understand that they may be forced to incur substantial expenses as a result of unforeseen events or circumstances beyond FF’s control, especially if fulfillment of the Experience involves travel. FF shall not have any responsibility or liability for expenses incurred by Recipient, relatives or friends which have not been expressly assumed by FF pursuant to this Agreement, which have been caused by unforeseen events, or circumstances beyond FF’s control. For example, a particular Experience may contemplate FF paying for certain specific expenses for a specific period of time while Recipient is traveling away from home. If Recipient’s medical condition deteriorates so that immediate hospitalization is necessary, Recipient may be forced to remain away from home longer than the period of time contemplated by the Experience. In that event, it will be the sole responsibility of the Recipient to pay for all expenses in excess of those for which FF has agreed to pay, whether medically-related, for meals and lodgings, including hospitalization, or for other goods, or services of any nature. If death occurs during Experience, FF is unable to assist in any way.

8. Fundraising. As a participant in Forward Foundation program, if needed, a campaign may be undertaken in your community, with your prior approval, to raise funds and/or frequent flyer miles to fulfill the Experience. Money raised will be used for your Experience up to a maximum allocation as described in item 7. Funds or miles raised above the allocation for your Experience will be used for future Experiences,

9. Representations and warranties. Recipient, relatives, friends, and participants, jointly and severally, make the following representations and warranties to FF: (a) they have made a true and full disclosure of all medical conditions to FF; (b) all information contained in the application and any materials provided in support of the application are true and correct in all material respects; (c) they will notify FF if and when Recipient’s medical condition should deteriorate at any time prior to fulfillment of the Experience; (d) they are carrying, or during the fulfillment of the Experience shall be carrying, full medical insurance, including any additional coverage which may be required as a result of the Experience to be fulfilled, or that they assume the risk and personal responsibility of failing to carry adequate medical insurance; (e) if fulfillment of the Experience involves travel, they are able to bear the financial burden of the potentially substantial expenses which they may be forced to personally incur as a result of unforeseen circumstances or events beyond FF’s reasonable control (as set forth in paragraph 7), and that they assume the risk and personal responsibility for such expenses; (f) Recipient has not previously been granted an Experience by FF or another charitable experience-granting organization; and (g) in requesting FF to fulfill the Experience, the Experience Recipient is not relying upon nor have they received any counsel or advice from FF with respect to the advisability of or the risks attendant to the Experience.

10. Termination of Experience. Forward Foundation shall terminate the preparation and/or fulfillment of the Experience after the signing of the Agreement, if: (1) Forward Foundation determines, after consulting with a medical professional, that fulfillment of the Experience may endanger the health or safety of Recipient or of others involved in the Experience; (2) Forward Foundation determines, after consulting with a medical professional, that the Recipient is or will be incapable of appreciating or utilizing the goods, services, or activities related to the Experience; (3) the Recipient passes away prior to the fulfillment of the Experience; or (4) FF determines, in its sole and absolute discretion, that the Experience Recipient, his or her Experience or the participants of the Experience do not compliment the values of the FF or those of its corporate partners; or (5) Recipient and any participants have breached any of the representations, warranties or covenants contained in this Agreement. In the event FF aborts preparation or fulfillment of the Experience, Recipient, and all participants agree that FF shall not be held liable or responsible for any expenses that Recipient, or any participants may have incurred in contemplation of FF’s fulfilling the Experience. NOTE: Only Forward Foundation may make a request for resources on behalf of an Experience. If the Experience Recipient, any participants, friends or anyone having knowledge of this Experience uses the name of Forward Foundation to solicit support, the Experience will be immediately disqualified and terminated.

11. Further assurances. Recipient and all participants agree that he or she shall, at the request of FF, execute and deliver to FF all further documents that FF deems necessary or appropriate in order to prepare, execute and fulfill the Experience, including without limitation, evidence of permission to perform a background check on the Recipient.

12. Counterparts. This Agreement may be executed in counterparts, any of which shall be deemed to be an original.

13. Amendment. This Agreement shall not be modified or superseded, except by a writing executed by the parties.

14. Governing law. The laws of ? shall govern this Agreement without regard to its conflict of laws principles

15. Binding effect. This Agreement is binding on all heirs, successors, representatives, and assigns of all parties hereto.

16. Severability. If any portion of this Agreement shall be determined to be invalid or unenforceable, all other portions shall remain valid and enforceable.

17. Entire agreement. This Agreement, the application and all materials provided in support of the application constitutes the entire Agreement and understanding of the parties with respect to the transaction contemplated hereby, and supersedes all prior agreements, arrangements and understandings related to the subject matter. No representation, promise, inducement or statement of intention has been made by any of the parties hereto not embodied in this Agreement and no party shall be bound by or liable for any alleged representation, promise, inducement or statements of intention not set forth or referred to herein.

18. Captions. The Captions appearing in this Agreement are for convenience and ease of reference only. They in no way describe, limit or extend this Agreement or any of its provisions.

19. Proof of financial hardship. Experience Recipient understands FF reserves the right to request documentation of financial hardship.

20. Grant of Right of Publicity. PARTICIPANTS UNDERSTAND AND AGREE THAT FULFILLMENT OF THE EXPERIENCE MAY RESULT IN PUBLICITY, WHETHER OR NOT THE FORWARD FOUNDATION ACTIVELY TAKES STEPS TO PUBLICIZE THE DREAM.

The Experience Recipient and Participants hereby irrevocably authorize FF: (a) to publicize and use Participants’ likenesses, voices and features, with or without their names, for any publication, promotion, advertisement, trade, business use, or any other purpose whatsoever in perpetuity; (b) to photograph, videotape, film, and record each participant in any manner the Forward Foundation chooses; (c) to copyright, convey, transmit or otherwise distribute, now or in the future, any such material involving the participants for any purpose to anyone, including the general public, through all media presently in existence or later invented, throughout the world, including without limitation print, video, television, radio, digital, internet, and social media; (d) to publicize, now or in the future, the names of the participants including information regarding them, their physical or emotional conditions and the details of any Experience granted.

The Experience Recipient and each of the participants agrees that it is not necessary for FF or anyone else to contact them prior to releasing any information authorized by this document. Each of the Participants hereby releases FF from all liability, damages, or claims of any kind resulting in or from, or arising from the use, distribution or disclosure of any photographs, films, videotapes, electronic recording or other information regarding Participants and the Experience.

Initial here: ___________________________________ (Must be initialed by ALL Participants)

By signing below, you affirm and acknowledge that you have read this Agreement, have retained a copy, and fully understand and agree to its provisions. All Participants must sign Agreement. For any minor Participants, the signature of their parent or guardian is both on behalf of the parent or guardian and on behalf of the minor.

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