Apply Now Omaha – Fiserv – FIN Future Techies

Fiserv Future Techies High School Submission Form – Due March 1

Your Name(Required)

First Last

High School(Required)

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Are you working with a team?(Required)

Yes

Team Member 1

First Last

Team Member 2

First Last

Team Member 3

First Last

Upload your prototype link or video here.(Required)

Drop files here or

Max. file size: 80 MB, Max. files: 4.

If you are submitting a link, please paste it into a Word document and upload that document. If your video exceeds 80 MB, you may upload it to YouTube and share the link, or upload it to Google Drive and share the link with katherine.frato@gmail.com. If you choose Google Drive, please upload a Word document stating “Shared via Google Drive”.

Upload your presentation here.(Required)

Drop files here or

Max. file size: 80 MB, Max. files: 4.

Additional Comments

Consent(Required)

I agree to

AUTHORIZATION, GENERAL RELEASE OF CLAIMS and WAIVER OF LIABILITY
TO PARTICIPATE IN THE FIN FUTURE TECHIES PROGRAM HOSTED at FISERV

I or my child/ward, (insert name) ____________________________wish to participate in the FIN Future Techies Program (“Experience”) hosted at Fiserv, Inc., or its affiliates, at (“Fiserv”) on . I understand that there may be risks involved with this Experience, and as a condition of my or my child’s or ward’s participation in the Experience, I assume and agree to all risks, whether apparent or not, that may result from this Experience. I agree for myself and my personal representatives, or for my child and his/her personal representatives, to the maximum extent permitted by law, to release and hold harmless Fiserv, its affiliates, and its and their employees, agents, officers and directors from and against all claims, demands, loss, damage, injury or causes of action, whether in tort, contract or otherwise, which I, or my representatives, or my child and his/her personal representatives, may have relating to participation in this Experience, to the maximum amount permitted by law. This means that I cannot sue or recover any damages from Fiserv if anything happens to me or my property, or my child or his/her property, in connection with the activities at Fiserv.
I hereby grant Fiserv permission to use and disclose any and all images of me or my child in all forms and media that Fiserv may obtain during the Experience. I understand that these images may be used in various publications, press releases, recruitment or educational materials, or for other related endeavors. These materials may also appear on the Fiserv website or social media.
I agree that this Authorization, Release of Claims and Waiver of Liability (“Release”) shall be governed by the laws of New Jersey, without regard to its choice of laws provisions.
I have read and understand this Release and I am aware that by signing this document I am waiving certain legal rights, including the right to sue for any and all injuries or losses that may arise in connection with or relate to the Experience. I am freely and voluntarily signing this Release.

Initials(Required)

Provide your initials here to agree for the above content

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