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Savills and the Company have and are prepared to make available to the Undersigned certain information concerning the Project and the Company, subject to the terms and conditions set forth below and any limiting conditions set forth in the Confidential Information (as hereinafter defined).
Parent Consent and Liability Release Form Name Birthday Address Phone City State Zip The undersigned does hereby give permission for our (my) child, _______________________________________ To attend and participate in activities sponsored by The Journey Church from January 1, 2016 to December 31, 2016.
___________________________________________________________ Signature of participant ______________________ Dated Leadership Summit 2015 Release and Indemnification Agreement WHEREAS, the undersigned is a student at Abilene Christian University (“ACU”) who has voluntarily applied for acceptance to attend and participate in the Leadership Summit at the Frontier Ranch located in Buena Vista, Colorado, January 3, 2015 through January 9, 2015 (hereinafter referred to as the SUMMIT);
I, the undersigned, do hereby acknowledge that all images submitted are original works that depict a vehicle owned by the undersigned.
For good valuable consideration, including without limitation the acceptance of the undersigned team member’s entry and or participation in the Cheeky Schoolie Tournament, and also for participating in activities related to the Cheeky Schoolie Tournament, the undersigned team member, for themselves, and personal representatives, heirs, guests, invites, employees and team members, hereby (1) RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE the following, which shall be known collectively as the "Releasees”:
Baird, the undersigned and counsel for the above-referenced Edward F.
BULK SALES AFFIDAVIT I, , the undersigned, being (title) of (Seller), of lawful age and first sworn, on oath state:
AUTHORIZATION The undersigned authorizes McLean County Foot and Ankle to release and/or obtain information in the course of treatment regarding medical condition of (patient’s name) __________________________________________to the previous named Insurance Company(s) and Physician(s).
A Judge of the Superior Court The undersigned hereby applies for a warrant for the arrest of the above-named accused on the basis of the facts ~ ffidavit Below.
PETITION TO the Legislative Assembly of Ontario ‐ WHEREAS – Multiple breaches of trust including the selloff of public assets (Hydro One) without referendum, Costly Green Energy initiatives forcibly bestowed on unwilling hosts, unpopular sex ed curriculum, payouts to teachers unions, HST, ORPP, death tax, and the lack of a RECALL trigger to correct these actions. WE the undersigned petition the Legislative Assembly of Ontario as follows. Enact a recall mechanism such as Randy Hillier’s Bill 89 so WE THE PUBLIC can initiate via petition a RECALL ELECTION when a MPP breaches the trust of his/her constituents. We likewise DEMAND THE LEADERS OF THE OPPOSITION make this an issue in the 42nd Ontario General Election. NAME (PRINTED) ADDRESS (PRINTED) SIGNATURE WE the undersigned petition the Legislative Assembly of Ontario as follows. Enact a recall mechanism such as Randy Hillier’s Bill 89 so WE THE PUBLIC can initiate via petition a RECALL ELECTION when a MPP breaches the trust of his/her constituents. We likewise DEMAND THE LEADERS OF THE OPPOSITION make this an issue in the 42nd Ontario General Election NAME (PRINTED) ADDRESS (PRINTED) SIGNATURE
26/08/2016 Total Consignments 1 Total Items 1 Total Pallets 0 Total Weight 10.000Kg Total Cube 0.112m3 Total Dangerous Goods Items 0 Dangerous Goods Declaration I, The undersigned, do declare that, to the best of my knowledge and understanding, this shipment does not contain any dangerous goods as defined in the Dangerous Goods Act.
0 Aviation Security and Dangerous Goods Declaration Aviation Security and Dangerous Goods Declaration I, the undersigned, do declare that to the best of my knowledge and understanding, this shipment does not contain any dangerous goods as defined in the Dangerous Goods Act.
EMERGENCY HÄCKER RECORDS COPYRIGHT LICENSE Agreement made and entered into on this hereinbelow date between the undersigned Alessandro Ruggi and the undersigned Emergency Häcker Records is as follows:
Lethbridge Citizens Alliance PETITION TO THE LEGISLATIVE ASSEMBLY OF ALBERTA We, the undersigned residents of Alberta, petition our Legislative Assembly to:
2:16-cr-00046–GMN-PAL ) 16 SECOND SUPPLEMENT TO PRO HAC VICE RE PETITIONER’S AND APPLICANT’S COMPLIANCE WITH COURT ORDER OF APRIL 2, 2016 AND SUPPLEMENT TO AND RENEWED VERIFIED PETITION FOR PERMISSION TO PRACTICE IN THIS CASE ONLY BY ATTORNEY NOT ADMITTED TO THE BAR OF THIS COURT AND DESIGNATION OF LOCAL COUNSEL PREVIOUSLY FILED ON MARCH 22, 2016 17 The undersigned counsel hereby again supplements Pro Hac Vice application of Attorney Larry 14 15 18 Klayman with the resume of renowned expert ethics Professor Ronald Rotunda, which was 19 inadvertently left off the prior filing.
19 20 21 The Plaintiff, Slep-Tone Entertainment Corporation, by its undersigned 22 counsel, hereby moves the Court pursuant to Local Rule 6-1 for an extension of 23 time for the parties to file their proposed discovery plan and scheduling order.
LIEN BY ATTORNEY The undersigned being the attorney of record on his own behalf and on behalf of any other attorney or attorneys who are associated with the undersigned or who are substituted in his stead for the above patient, does hereby agree to observe all the terms of the above and agrees to withhold such sums from any settlement, judgment or verdict as may be necessary to adequately protect, Alpha 3T MRI &
5:11cv32/RS/CJK _______________________________________________________________ ORDER SETTING SETTLEMENT CONFERENCE The district court referred this case to the undersigned for a settlement conference (see doc.
In consideration of being allowed to participate in any way in the European Moo Duk Kwan Tang Soo Do Championships, the undersigned, the parent or guardian of a minor child participant:
PARTICIPANT WAIVER OF CLAIMS AND LIABILITY RELEASE In consideration of his acceptance as a participant in the National Football League’s High School Player Development Program (the “Program”) held by the National Football League Foundation (“Foundation”), the undersigned participant (“Participant”) and his parent(s) or legal guardian(s) agree to this Participant Waiver of Claims and Liability Release (the “Waiver and Release”), which will cover events occurring from the time Participant commences his participation in the Program until the termination of his participation therein.
○ Headaches/Migraines ○ Neck Pain ○ Shoulder Pain ○ Mid/Upper Back Pain ○ Low Back Pain ○ Hip/Pelvic Pain ○ Sciatica ○ Elbow/Wrist Pain ○ Knee/Ankle Pain ○ Other Serious Injuries ○ Arthritis ○ Herniated Disc ○ Joint Replacements ○ Osteoporosis/Osteopenia ○ Tumors ○ Cancer ○ Stroke ○ Seizures ○ High Blood Pressure ○ Allergies ○ Aids/HIV ○ Diabetes ○ Hepatitis ○ TB ○ Hernia ○ Heart disease ○ Other ________________________________________________________ ____________________________________________ Patient Acknowledgment and Receipt of Notice of Privacy Practices Pursuant to HIPAA and Consent for Use of Health Information The undersigned does hereby acknowledge that he or she has received a copy of this office’s Notice of Privacy Practices Pursuant To HIPAA and has been advised that a full copy of this office’s HIPAA Compliance Manual is available upon request.
17-cv-3712 COMPLAINT Plaintiff Abreziel Holdings AG (“Abreziel”), by its undersigned attorney, for its Complaint against defendants Passo Sync, Inc.
Per Annum ………………………………………………………………….…………………I am the undersigned hereby declare that the information given in this application is correct to the best of my knowledge and belief.
volunteer activities and all related activities, including any activities incidental to such participation (“Volunteer Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under age 18 (hereafter referred to using “I”, “me”, or “my”) releases and agrees not to sue Her Broken Silence, Inc.
(The agent, broker, producer or agency undersigned hereto is hereinafter collectively referred to as “Agent”;