I certify that I am qualified, in good health and in proper physical condition to participate in the 2009 Walkabout Abilities. I acknowledge and understand fully that there are risks and dangers of serious bodily injury and death that could result from my participation in the event from any cause. I fully accept responsibility for any injury, losses and damages to person or property that I incur as a result of my participation in the event. I hereby grant Abilities Network specific permission to reproduce, publish, circulate, copyright or otherwise use any and all photographs and/or video of me and/or my family, taken at the Epilepsy Awareness Walk to benefit Abilities Network, for use by Abilities Network.