JEVS Human Services + ON THE GOGA


I, undersigned employee ("Participant"), desire to participate in the Jevs Human Services Trial Program (“Trial Program”), which will be administered by On the Goga (“OTG”) on at Jevs Human Services (“Employer”) in locations including but not limited to the Jevs Human Services offices located at 1845 Walnut St, 7th Floor, Philadelphia, PA 19103; 1617 JFK Blvd, 2nd Floor, Philadelphia, PA 19103; 9350 Ashton Rd, Suite 201, Philadelphia, PA 19114; and 2770 Red Line Rd, Philadelphia, PA 19114 from October 1, 2018-December 31, 2018.  I represent that I am over the age of eighteen (18) and at a physical and mental health level appropriate to participate in the Trial Program. I do not suffer from any medical conditions or disabilities that may restrict, limit, prevent, or preclude participation in the Trial Program, including any physical activities. I further represent that I am responsible for determining whether I am physically and medically able to participate in the Trial Program, and I am solely responsible for determining whether I can or should continue my participation during the Trial Program.

I understand that my participation in the Trial Program is not mandatory and will have no effect on my employment with Employer. I further recognize and understand that my participation in the Trial Program does not and will not inure any benefit to Employer.

I agree to be personally liable for all costs of treatment or care, or other financial expenditures that may arise after my participation in the Trial Program.

I understand that OTG has reserved the right, to refuse my participation in the Trial Program, due to my physical health and/or fitness abilities, or if I demonstrate behavior that may result in injury to anyone.

In consideration of my participation in any aspect of the Trial Program, I release and discharge Jevs Human Services, On the Goga, LLC, and On the Goga, LLC’s employees from any liability for injuries that may result from my participation in the Trial Program.

Photo Release

This release applies to all photographic, audio, and/or video recordings collected as part of, in connection with, and/or during the Trial Program. By and in consideration for being permitted to participate in the Trial Program, Participant irrevocably grants On the Goga LLC and its agents and representatives all rights to use, reproduce, display, exhibit, publish, distribute, and/or produce derivative works based on any and all images, likenesses, and voices as recorded by any camera and/or on any video, audio, and/or other media (collectively, “Likeness”) of Participant, worldwide, in perpetuity, without compensation, payment, or other additional consideration of any kind, for any lawful purpose, including without limitation for marketing and trade purposes. Participant agrees that Participant’s likeness may be used, reproduced, displayed, exhibited, published, edited, or distributed by OTG at its sole discretion.  Participant understands that Participants’ Likeness may be used in various publications, promotional or marketing materials, and/or social media, unrestricted by time or geographic area and consent to such uses. Participant further understands and grants permission to On the Goga LLC and its agents and representatives to electronically display Participants’ Likeness on the Internet or in other public settings. Participant hereby waives the right to inspect or approve any and all materials in which Participants’ Likeness may appear. Participant further waives any right to royalties or other compensation arising or related to the use of Participants’ Likeness. There is no time limit on the validity of this release nor is there any geographic limitation on where materials including Participants’ Likeness may be used, reproduced, displayed, exhibited, published, and/or distributed by or on behalf of On the Goga LLC.