Fourth Annual Purple Day®
For Epilepsy Awareness
Around The World Expo

Saturday, March 25, 2023
at Disney's Contemporary Resort in Florida

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FIRST 200 TO REGISTER WILL BE ENTERED IN A DRAWING TO WIN 4 FREE TICKETS TO DISNEY!

Tickets are $10 for adults (18 years and older) and FREE for all children (Under 18). The ticket includes entrance to the Fourth Annual Purple Day® For Epilepsy Awareness Around The World and Expo, access to all break out sessions, meet and greet/photos with Mickey and Minnie, participation in group photo with Minnie and mickey, fun activities, giveaways, light refreshments, engagement with members of the epilepsy community, and an official PURPLE DAY® SWAG BAG!

Date: Saturday, March 25, 2023

Time: 9AM to 5 PM

Where: Disney's Contemporary Resort - Fantasia Hall
4600 World Dr, Lake Buena Vista, FL 32830

PLEASE READ:

This is a private in-person event at Disney’s Contemporary Resort.
This ticket does NOT include entrance to any of the Disney Parks.
Purple Day 2023 Registration Form
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Adult Attendee

Adult Attendee

Adult Attendee (18 and over): $10.00

Child Attendee

Child Attendee

Child Attendee (under 18): $0.00

Total

Waiver and Permission Form For Adults and Minors (under 18 years of age) Terms and Conditions of Attendance / Participation – Read Carefully Before Signing

In consideration of you and your minor child(ren) and or ward(s), being permitted to participate in the above non-commercial event, you agree as follows:

Assumption of Risk/Liability Release and Indemnify: I on behalf of myself and or my child(ren) and or my ward(s) agree to assume all of the risks of personal injury, as well as the risk of negligence by the Released Parties for all liabilities, claims or expenses arising out of or in connection with this event. I and my child(ren) and my ward(s) hereby release, covenant not to sue, and forever discharge the Released Parties from all liabilities, claims or expenses arising out of or in any way connected with this event and further agree to indemnify and hold harmless each of the Released Parties from all claims including but not limited to all attorneys’ fees and disbursements through and including any appeal. The Released Parties are The Anita Kaufmann Foundation and The Epilepsy Association of Central Florida, Inc. and their directors, officers, employees and volunteers of each of the foregoing entities.

Publicity Rights: I grant the Released Parties (see above) the right to photograph, record and/or videotape me and or my child(ren) and or ward(s) and further to display, edit, use and/or otherwise exploit me or my child(ren) and or ward(s)’s name, face, likeness, voice, and appearance in all media, whether now known or hereafter devised, without limitation, throughout the universe in perpetuity, whether for advertising, publicity, fundraising or promotional purposes, without compensation reservation or limitation, or further approval, and also further agree to indemnify and hold harmless the Released Parties for any claims associated with such grant and right to use. The Released Parties are however under no obligation to exercise any rights granted herein.

Governing Law: This Waiver and Permission Form shall be governed by the laws of the State of New Jersey, and any legal action relating to or arising out of this Waiver and Permission Form shall be commenced exclusively in the New Jersey Superior Court of Bergen County, New Jersey (or if such court does not have jurisdiction, then to Federal District Court sitting in Newark, New Jersey), and specifically waiving the right to trial by jury.

 

NOTICE TO THE MINOR CHILD’S OR WARD’S NATURAL GUARDIAN(S) REQUIRED UNDER FLORIDA STATUTES 744.301. PLEASE READ BEFORE SIGNING

YOU ARE AGREEING TO LET YOUR MINOR CHILD OR WARD PARTICIPATE IN THE 4TH ANNUAL PURPLE DAY® FOR EPILEPSY AWARENESS EVENT AROUND THE WORLD 2023. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD’S OR WARD’S RIGHT AND YOUR RIGHT TO RECOVER FROM THE ANITA KAUFMANN FOUNDATION AND THE EPILEPSY ASSOCIATION OF CENTRAL FLORIDA, INC. IN A LAWSUIT FOR PERSONAL INJURY, PUBLICATION OF NAME OR LIKENESS OR INVASION OF PERSONAL PRIVACY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE ANITA KAUFMANN FOUNDATION HAS THE RIGHT TO REFUSE TO LET YOUR CHILD OR WARD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

By signing below, I certify that: (1) I have fully and completely read and understand this Waiver and Permission Form; (2) I am 18 years of age or older; (3) I am the legal guardian of the minor child(ren) and or ward(s) identified below; and (4) I consent and agree to all of the foregoing on behalf of myself and my minor child(ren)and or ward(s) identified below.

First and Last Name of Minor/Ward and Date of Birth

Name of Parent or Court Appointed Guardian

Adult Attendees Information

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