THIS GIFT AGREEMENT (the “Agreement”) is made effective as of this ______ day of _________________, 2022.

 

Please initial items 2, 3, 4, 5 and 20 where indicated, below:

 

1.         Granting of Gift. FROM MOM WITH LOVE FOUNDATION INC. (the “Foundation”) shall assist with the Gift request for the person identified below (“Recipient”) and Recipient’s dependent children, subject to the terms and conditions set forth in this Agreement. The Foundation reserves the right in its sole and absolute discretion, to decide if a Gift will be granted and on what terms. The Foundation shall have no obligation to fulfill any Gift hereunder if it elects to terminate or abandon such Gift pursuant to section 10 below.

 

2.         Permission to Disclose Medical Condition. Recipient grants the Foundation the right to disclose the nature of her medical condition to the extent necessary in the fulfillment of the Gift. Furthermore, the Recipient grants the Foundation permission to obtain medical information about the recipient which the Foundation may feel necessary for fulfillment of the Gift and authorizes all physicians and medical care providers to provide the Foundation with all medical information. ________ [initial here]   

 

3.         Waiver. The Recipient and all participants hereby forever waive any and all rights or claims she or he may have or may hereafter acquire against the Foundation, its officers, directors, agents, and employees arising out of any injury, harm damage or loss of any kind to body or property, including without limitation the transmission of infectious or communicable disease and/or attorneys’ fees (collectively “Losses”) suffered or incurred by Recipient, and any participant, arising out of or in any way related to the Foundation’s preparation, execution or fulfillment of the Gift, whether or not such Losses were caused by the active, passive or gross negligence or omission of the Foundation or any other person. ________ [initial here]      

 

4.         Release. Recipient, and all participants, together, and each of them individually, do hereby forever release and hold the Foundation, its officers, directors, agents, and employees harmless from any and all Losses suffered or incurred by Recipient or any participant arising out of or in any way related to the Foundation’s preparation, execution or fulfillment of the Gift, whether or not such Losses were caused by the active, passive or gross negligence of the Foundation or any other person. ________ [initial here]

 

5.         Indemnity. Recipient, and all participants, jointly and severally, do hereby agree to indemnify and hold the Foundation, its officers, directors, agents, and employees harmless of and from any and all Losses suffered or incurred by the Foundation, its officers, directors, agents, and employees as the result of any claim, lawsuit, or action arising from the actions or omissions of Recipient and any participant during the preparation, execution and fulfillment of the Gift, or due to a breach by Recipient, or any participants, of the representations, warranties or covenants contained in this agreement. Said hold harmless and indemnity includes, but is not limited to, reasonable attorneys’ fees and costs incurred by the Foundation, it officers, directors, agents, and employees in retaining attorneys of the Foundation’s choice to defend any and all such claims, lawsuits, and actions. ________ [initial here]

 

6.         Relatives/Friends. When applicable, no person may accompany the Recipient and/or participant during any portion of the Gift fulfillment, unless specifically agreed to in writing between the Foundation and Recipient or participant.

 

7.         Gift Expenses. The expenses the Foundation has agreed to pay for are those foreseeable and directly related to the fulfillment of the Gift. Recipient, participants, relatives or friends, together understand that they may be forced to incur substantial expenses as a result of unforeseen events or circumstances beyond the Foundation’s control, especially if fulfillment of the Gift involves travel. The Foundation shall not have any responsibility or liability for expenses incurred by Recipient, participants, relatives or friends which have not been expressly assumed by the Foundation pursuant to this Agreement, which have been caused by unforeseen events, or circumstances beyond the Foundation’s control. The maximum amount that the Foundation will spend on this Gift is $10,000.00.

 

8.         Fundraising. As a participant in Gift program, if needed, a campaign may be undertaken in your community, with your prior approval, to raise funds to fulfill the Gift. Money raised will be used for your Gift up to a maximum allocation as described in item 7. Funds raised above the allocation for your Gift will be used for future Gifts.

 

9.         Representations and Warranties. Recipient, relatives, friends, and participants, jointly and severally, make the following representations and warranties to the Foundation:

 

(a)        they have made a true and full disclosure of all medical conditions to the Foundation;

 

(b)        all information contained in the application and any materials provided in support of the application are true and correct in all material respects;

 

(c)        they will notify the Foundation if and when Recipient’s medical condition should deteriorate at any time prior to fulfillment of the Gift;

 

(d)       they are carrying, or during the fulfillment of the Gift shall be carrying, full medical insurance, including any additional coverage which may be required as a result of the Gift to be fulfilled, or that they assume the risk and personal responsibility of failing to carry adequate medical insurance;

 

(e)        if fulfillment of the Gift involves travel, they are able to bear the financial burden of the potentially substantial expenses which they may be forced to personally incur as a result of unforeseen circumstances or events beyond the Foundation’s reasonable control (as set forth in paragraph 7), and that they assume the risk and personal responsibility for such expenses;

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(f)        if fulfillment of the Gift involves travel or the gathering, participation in or exposure to large groups, they are fully aware of the health and safety risks associated with such Gifts, including without limitation potential exposure to infectious or communicable disease, impositions or quarantine, restrictions of movement and or travel advisories, the threat of such risks, or the occurrence of any loss, damage cost or expense, including Losses, as a result.

 

(g)        Recipient has not previously been granted a Gift (or similar benefit) by the Foundation or another charitable organization;

 

(h)        Recipient does not have a pending application for a Gift (or similar benefit) from another charitable organization; and

 

(i)         in requesting the Foundation to fulfill the Gift, the Recipient is not relying upon nor have they received any counsel or advice from the Foundation with respect to the advisability of or the risks attendant to the Gift.

 

10.       Termination of Gift. The Foundation may terminate the preparation and/or fulfillment of the Gift after the signing of the Agreement, if: (1) the Foundation determines, after consulting with a medical professional, that the Recipient and/or participant is or will be incapable of appreciating or utilizing the goods, services, or activities related to the Gift; (2) the Recipient and/or participant passes away prior to the fulfillment of the Gift; (3) the Foundation determines, in its sole and absolute discretion, that the Recipient, her Gift or the participants of the Gift do not complement the values of the Foundation; (4) Recipient and any participants have breached any of the representations, warranties or covenants contained in this Agreement, or (5) the Gift is in violation of the rules, policies or procedures of the Foundation, in effect from time to time. In the event the Foundation aborts preparation or fulfillment of the Gift, Recipient, and all participants agree that the Foundation shall not be held liable or responsible for any expenses that Recipient, or any participants may have incurred in contemplation of the Foundation’s fulfilling the Gift. NOTE: Only the Foundation may make a request for resources on behalf of a Gift. If the Recipient, any participants, friends or anyone having knowledge of this Gift uses the name of the Foundation to solicit support, the Gift may be immediately disqualified and terminated, in the sole discretion of the Foundation.

 

11.       Further Assurances. Recipient, and all participants agree that she or he shall, at the request of the Foundation, execute and deliver to the Foundation all further documents that the Foundation deems necessary or appropriate in order to prepare, execute and fulfill the Gift, including without limitation, evidence of permission to perform a background check on the Recipient.

 

12.       Counterparts. This Agreement may be executed in separate counterparts, each of which when so executed and delivered will be an original, but all of which together will constitute one and the same agreement.  In pleading or proving this Agreement, it will not be necessary to produce or account for more than one such counterpart.

 

13.       Amendments. This Agreement shall not be modified or superseded, except by a writing executed by the parties.

 

14.       Governing Law and Jurisdiction. The laws of the State of Illinois shall govern this Agreement without regard to its conflict of laws principles. The Recipient and the participants agree to submit to the exclusive jurisdiction and venue of any court located within the State of Illinois. 

 

15.       Binding Effect. This Agreement is binding on all heirs, successors, representatives, and assigns of all parties hereto.

 

16.       Severability. If any portion of this Agreement shall be determined to be invalid or unenforceable, all other portions shall remain valid and enforceable.

 

17.       Entire Agreement. This Agreement, the application and all materials provided in support of the application constitutes the entire Agreement and understanding of the parties with respect to the transaction contemplated hereby, and supersedes all prior agreements, arrangements and understandings related to the subject matter. No representation, promise, inducement or statement of intention has been made by any of the parties hereto not embodied in this Agreement and no party shall be bound by or liable for any alleged representation, promise, inducement or statements    of intention not set forth or referred to herein.

 

18.       Captions. The captions appearing in this Agreement are for convenience and ease of reference only. They in no way describe, limit or extend this Agreement or any of its provisions.

 

19.       Proof of Financial Hardship. Recipient understands the Foundation reserves the right to request documentation of financial hardship.

 

20.       Grant of Right of Publicity. RECIPIENT AND PARTICIPANTS UNDERSTAND AND AGREE THAT FULFILLMENT OF THE GIFT MAY RESULT IN PUBLICITY, WHETHER OR NOT THE FOUNDATION ACTIVELY TAKES STEPS TO PUBLICIZE THE GIFT.

 

The Recipient and participants hereby irrevocably authorize the Foundation: (a) to publicize and use Recipient’s and participants’ likenesses, voices and features, with or without their names, for any publication, promotion, advertisement, trade, business use, or any other purpose whatsoever in perpetuity; (b) to photograph, videotape, film, and record each participant in any manner the Foundation chooses; (c) to copyright, convey, transmit or otherwise distribute, now or in the future, any such material involving the participants for any purpose to anyone, including the general public, through all media presently in existence or later invented, throughout the world, including without limitation print, video, television, radio, digital, internet, and social media; (d) to publicize, now or in the future, the names of the participants including information regarding them, their physical or emotional conditions and the details of any Gift granted.

 

The Recipient and each of the participants agrees that it is not necessary for the Foundation or anyone else to contact them prior to releasing any information authorized by this document. Each of the Recipients and participants hereby releases the Foundation from all liability, damages, or claims of any kind resulting in or from, or arising from the use, distribution or disclosure of any photographs, films, videotapes, electronic recording or other information regarding Recipient and/or participants and the Gift.

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Initial here:                                                                                                       (Must be initialed by ALL participants and recipient) For any minor participants, the initials/signature of their parent or guardian is both on behalf of the parent or guardian and on behalf of the minor.

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By signing below, you affirm and acknowledge that you have read this entire Agreement, have retained a copy, and fully understand and agree to its provisions. Recipient and all participants must sign this Agreement. For any minor participants, the initials/signature of their parent or guardian is both on behalf of the parent or guardian and on behalf of the minor.

 

I understand and agree that providing false or misleading information in my application may result in withdrawal of my application and termination of the Gift.

 

 

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Gift Participant                      Date

 

 

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