Step 1

Participant details

Enter date of birth to determine minor status

Step 2

Review the waiver packet

Read both documents below. On submit, the application generates a signed PDF packet that combines these waivers for Glitch Gemini Hackathon and emails a copy to the signer for their records when receipt delivery is configured.

Included form

Waiver of Liability, Assumption of Risk, and Indemnity Agreement

University of California, Los Angeles

This electronic packet captures the content of the student organization liability waiver for this event.

Student organization / clubGLITCH
Activity description
Name: Glitch Gemini HackathonDate: 3/27/2026 - 3/28/2026Location: Carnesale Commons

Parent or legal guardian signature is only required if the participant is under 18.

Waiver

In return for being permitted to participate in the following activity or program (“The Activity”), including any associated use of the premises, facilities, staff, equipment, transportation, and services of the University, I, for myself, heirs, personal representatives, and assigns, do hereby release, waive, discharge, and promise not to sue The Regents of the University of California, and the student organization/club listed below, and their respective directors, officers, employees, and agents (collectively “The Releasees”), from liability from any and all claims, including the negligence of The Releasees, resulting in personal injury (including death), accidents or illnesses, and property loss, in connection with my participation in the Activity and any use of University premises and facilities.

Assumption of Risks

Participation in The Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injury. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains, to 2) major injuries such as eye injury, joint or bone injuries, heart attacks, and concussions, to 3) catastrophic injuries such as paralysis and death.

Indemnification and Hold Harmless

I also agree to indemnify and hold The Releasees harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, arising out of my involvement in The Activity, and to reimburse it for any such expenses incurred.

Severability

I further agree that this Waiver of Liability, Assumption of Risk, and Indemnity Agreement is intended to be as broad and inclusive as permitted by law, and that if any portion is held invalid the remaining portions will continue to have full legal force and effect.

Governing Law and Jurisdiction

This Agreement shall be governed by the laws of the State of California, and any disputes arising out of or in connection with this Agreement shall be under the exclusive jurisdiction of the Courts of the State of California.

Acknowledgment of Understanding

I have read this Waiver of Liability, Assumption of Risk, and Indemnity Agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I confirm that I am signing the agreement freely and voluntarily, and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

If the participant is a minor, the parent or legal guardian agrees to the waiver on behalf of the participant.

Included form

Media Release and Authorization

Glitch Gemini Hackathon

This authorizes event-related photography, video, audio, livestream, and promotional use connected to the hackathon.

Parent or legal guardian consent is only required if the participant is under 18.

Authorization

I authorize GLITCH and the Glitch Gemini Hackathon organizers to photograph, film, record, livestream, or otherwise capture my participation in the event, including my name, likeness, image, voice, statements, project demonstrations, and team participation.

Permitted Uses

I grant permission for those recordings and materials to be used, edited, reproduced, published, displayed, distributed, and archived for event operations, recap materials, educational content, websites, social media, press coverage, sponsor updates, and future promotion of Glitch Gemini Hackathon and related programming.

No Compensation or Prior Approval

I understand that I will not receive compensation for the authorized use of these materials unless a separate written agreement states otherwise. I also understand that I may not be able to inspect or approve every finished use before publication, except as may be required by law.

Participant Responsibility

I understand that I should not disclose confidential, proprietary, or otherwise restricted materials during any interview, demonstration, or recording unless I have permission to do so.

Future Use Requests

For future promotional uses that have not yet been published, you may contact the event organizers at yxiao1717@gmail.com. Materials already printed, posted, broadcast, archived, or shared may not be able to be withdrawn.

Release

To the extent permitted by law, I release GLITCH and the Glitch Gemini Hackathon organizers from claims arising out of the authorized use of these recordings and materials.

Step 3

Acknowledge and sign

The participant must sign here.

Submitting will create a signed PDF packet, store the JSON audit record, and email the packet back to the signer when receipt delivery is enabled.