Release – Adult Participants with Care Partners

Sweet Readers, Inc. (”Sweet Readers”) is a 501(c)3 tax exempt public charity formed in New York, New York, USA in 2011. Our mission is to empower young people through training, transformative programs and communities of support to engage adults living with Alzheimer’s and related disorders (”AD”) and become catalysts for excellence in eldercare. During our programs, young people are challenged to utilize science, human engagement and the arts to discover the person and meaningfully connect.

The Sweet Readers multigenerational programs (the “Programs”), delivered in partnership between Sweet Readers, middle schools and in some cases major museums (the “Partners”) are held in school classrooms, museums and eldercare centers. Programs are led by a trained facilitator utilizing one of the customized Sweet Readers curricula. We are happy to be able to include the adult named at the end of this Agreement (”Adult Participant”) and the care partner named at the end of this release (”Care Partner”) in the program and are delighted that the program fee for adult participants, $25 per session for each full 5-9 session program, is being covered by our partners. Thank you for your support and participation!

General Release

I acknowledge and agree:

•In the interest of consistency and fostering meaningful connections, I will make best efforts to ensure that the Adult Participant and Care Partner attend every session of each Program for which they have signed up. If Adult Participant is unable to attend, then I agree to notify Sweet Readers as soon as practically possible either by phone: 917.828.2970 or by email: programs@sweetreaders.org.

• If the Care Partner is replaced or I would like to add an alternate Care Partner(s) for these programs, then I will email programs@sweetreaders.org with the name and cell phone number for the replacement Care Partner(s), placing the words “Replacement Care Partner” in the email subject line, at least 24 hours prior to any program session they plan to attend, if possible.

• The Adult Participant and their Care Partner or replacement Care Partner will be, for each program session they attend, to the best of my knowledge, in good health and able to undertake the normal range of activities contemplated by the Program and will not attend the program if feverish, ill or with any communicable diseases or viruses. I also acknowledge that as a condition of participating in the Program, the Adult Participant and their Care Partner possess comprehensive medical/health insurance which will be in effect throughout their participation in the Program;

• The Care Partner and/or any replacement Care Partner, each with experience with AD and working with the Adult Participant, will be present throughout all program sessions and responsible for any care needs of the Adult Participant which may arise. If Adult Participant does not require a Care Partner, as pre-approved by the Adult Participant’s primary care physician, then I hereby give permission for the Adult Participant to attend on their own, will provide an emergency contact that can be reached immediately by cell/text at the number provided at the end of this Agreement and will be personally and fully liable for any care needs, injuries or accidents which may occur during the course of the Program and including during the Adult Participant’s transportation to and from the Program; and

• Both the Adult Participant and Care Partner remain fully subject to the rules and regulations of Sweet Readers and its Partners concerning their conduct, including the right of Sweet Readers or any of its Partners to suspend, limit or terminate their participation in the Program for any reason Sweet Readers or the Partners deem proper.

Image, Voice & Works Release

I hereby irrevocably consent to and authorize Sweet Readers to use any photographs, audio and/or videos of the Adult Participant and the Care Partner and/or any works (artworks, poetry, etc.) either party may create during the course of the Program in order to promote and publicize Sweet Readers, its mission and its programs, in any medium. Sweet Readers agrees not to publish the Adult Participant’s or Care Partner’s last name without my prior written permission.I further acknowledge that Sweet Readers is the owner of all rights in and to the aforemen- tioned photographs, videos and/or works.

By signing below I agree to allow the Adult Participant and Care Partner to participate in the Program and hereby release and will indemnify and hold harmless Sweet Readers, its employees, officers, directors, agents and represen- tatives, to the fullest extent permitted by applicable law, from all claims, demands and liability of any kind including without limitation, all personal injuries including loss of life and expenses including reasonable attorney’s fees, arising either the Adult Participant’s or Care Partner’s participation in the Program and/or the display, distribu- tion, reproduction or other use of the photos, videos, audio and/or works which may be produced during or for the Program, excluding claims arising directly from the willful misconduct or grossly negligent acts of Sweet Readers. The indemnity set forth in this paragraph shall survive termination of this Release.

By signing below, I warrant that I have the right to enter into this Agreement, including, without limitation, on behalf of the Adult Participant and agree to the terms and conditions set forth in this Agreement. I warrant the information I am providing below is accurate. I also agree to require the person accompanying the Adult Participant to the sessions to review and agree to the terms and conditions of this Agreement as a condition of serving in such role.