XR Consent to Create Account and Waiver

First Name:(Required)

Last Name:(Required)

Address:(Required)

City:(Required)

Postal Code:

Telephone:(Required)

Email Address:(Required)

Territory:(Required)

Community / Education Partner:(Required)

Technology Being Used:(Required)

Name of Platform:(Required)

1. By clicking Yes, I give Contact North | Contact Nord consent to create accounts in my name and using my email address for agreed upon education and training providers(Required)

Yes

2. By clicking Yes, I give Contact North | Contact Nord consent to accept any terms and conditions on my behalf when creating such accounts;(Required)

Yes

3. By clicking Yes, I give Contact North | Contact Nord consent to access my account(s) to confirm completion of any courses; and(Required)

Yes

4. By clicking Yes, this consent remains in place for a period of two (2) years from the date of signing or until such time I revoke the consent in writing. Upon revoking the consent, I will immediately change the password on the account to prevent any further access.(Required)

Yes

PARTICIPANT RELEASE AND WAIVER

PLEASE READ CAREFULLY!

This Release and Waiver (“Waiver”) constitutes a legal agreement and is entered into by and between the individual named below (“I” or me”) and Contact North | Contact Nord (“Contact North”).

In consideration of Contact North permitting me to participate in its fully immersive virtual reality equipment and by using this equipment or clicking to accept this Waiver, I acknowledge I read, understood and accept these terms and conditions and agree I am legally bound by these terms.

Assumption of Risks

I am aware and understand:

(1) The use of the equipment may cause nausea*; and

(2) I must remain seated at all times while in the virtual reality environment and that standing involves risks, dangers, and hazards, including but not limited to, the risk of serious injury or property damage. **

I acknowledge that I am voluntarily participating in the activities. I freely accept and fully assume any and all of the risks, dangers, and hazards involved and the possibility of injury or property damage, whether caused by the negligence of Contact North or otherwise.

I acknowledge that I have read and understood all of the terms of this Waiver and that I am voluntarily waiving substantial legal rights (on my behalf and on behalf of my heirs, executors, administrators, and next-of-kin).

* You can switch to the PC version if you experience nausea while participating in VR mode, which may alleviate some of the symptoms.

** A PC version is available to you if you are not comfortable with this Waiver.

CONFIRMATION

I understand I am able to revoke this consent at any time by writing to Contact North | Contact Nord. This consent form expires two years from the date of signing unless revoked by me prior to that date.

Signature(Required)

Date(Required)

To Be Completed by the Parent or Guardian (If participant named above is under 18)

I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Consent to Register and Release of Liability and Waiver of Claims.

First Name

Last Name

Signature

Date

Follow this link to Contact North | Contact Nord's Privacy Policy

40637

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