NEW AMBASSADORS

2026 Impact Retreat Registration

Commitment to Attend(Required)

I ATTENDED last year’s retreat and am committed to attending this year.

I am a NEW ambassador this year and am committed to attending if space is available.

I am and EXISTING ambassador and am committed to attending if space is available

Last year’s attendees are guaranteed acceptance. Remaining applicants are based on space available, but generally we can accommodate everyone. By clicking this button you agree to attend the entire retreat and will not cancel. Much time, effort and expense will go into ensuring an excellent event and there are many attendees who would like to attend. Please consider and affirm your willingness to commit to attending.

Name(Required)

First Last

Email(Required)

Cell Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Unisex T-Shirt Size(Required)

MED

2XL

3XL

4XL

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Roommate Choice 1

Roommate Choice 2

Roommate Choice 3

We will strive to pair you with one of your preferred roommates, but cannot guarantee a perfect match. Flexibility may be necessary to optimize roommate assignments. Please leave this section blank if you would like us to choose a roommate for you. We do not offer single rooms so if you are not able to share a room, we understand but this might not be the right event for you.

Check all health or dietary considerations we should be aware of.

Gluten Free

Nut Allergy

Shellfish Allergy

Vegetarian

Vegan

Other Dietary Concern-Explain below

Wheelchair or other accommodation requested

Any other health concerns or issues we should be aware of?

I understand the retreat will take place in Las Vegas during summer where day-time temperatures can be over 100 degrees Farhenheit. While many activities will be held inside, I understand I am responsible for monitoring my care and if I have health concerns regarding susceptibility to heat stroke I will discuss this with my doctor before attending(Required)

I understand.

Legal Mumbo Jumbo

Photo Consent(Required)

I agree to the photo policy.

PHOTO RELEASE
For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby grant Alane Adams LLC and Rise Up Foundation permission to use my likeness in a photograph in any and all of its publications, including but not limited to all of Alane Adams LLC’s and Rise Up Foundation’s printed and digital publications. I understand and agree that any photograph using my likeness will become property of Alane Adams LLC and Rise Up Foundation and will not be returned.
I acknowledge that since my participation with Alane Adams LLC and Rise Up Foundation is voluntary, I will receive no financial compensation.

By clicking here I agree to the Code of Conduct.(Required)

I agree to the code of conduct policy.

Code of Conduct

All participants in the Impact Retreat including faculty, staff, and attendees, are required to comply with the following code of conduct:
• Be respectful of others at all times
• Be mindful of differing points of views
• Be courteous
Our Anti-Harassment Policy prohibits harassment, including but not limited to the following behaviors:

• Deliberate intimidation, stalking, or following.
• Sustained disruption of talks or other events.
• Inappropriate physical contact.
• Unwelcome attention.
• Abusive verbal comments.

Harassment does not include respectful disagreement or reasonable and respectful critique made in good faith.

Consent(Required)

I agree to the release of liability.

RELEASE OF LIABILITY
IMPACT RETREAT July 6-10, 2026
In exchange for participation in the IMPACT RETREAT organized by Rise Up Foundation, Alane Adams and Alane Adams Studios LLC [“The Group”], of 158 N. Glassell St., Orange, California, 92866 and/or use of the property, facilities and services of The Group, I agree to the following:
1. AGREEMENT TO FOLLOW DIRECTIONS. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by The Group, or the employees, representatives or agents of said.
2. ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and further release and discharge The Group for injury, loss or damage arising out of my use of or presence upon
the facilities of The Group, whether caused by the fault of myself, The Group or other third parties.
3. INDEMNIFICATION. I agree to indemnify and defend The Group against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my use of or presence upon the facilities of The Group.
4. FEES. I agree to pay for all damages to the facilities of The Group abused by any negligent, reckless, or willful actions by me.
5. APPLICABLE LAW. Any legal or equitable claim that may arise from participation in the above shall be resolved under California law.
6. NO DURESS. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge
that I am free to have my own legal counsel review this Agreement if I so desire. I further agree and acknowledge that The Group has offered to refund any fees I have paid to use its facilities if I choose not to
sign this Agreement.
7. ARM’S LENGTH AGREEMENT. This Agreement and each of its terms are the product of an arm’s length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement, or any of its provisions, the Parties, and each of them, explicitly reject the application of any
legal or equitable rule of interpretation which would lead to a construction either “for” or “against” a particular party based upon their status as the drafter of a specific term, language, or provision giving rise to
such ambiguity. Accordingly, the Parties specifically reject the application of Cal. Civ. Code §1654 to this Agreement, as well as any other statute or common law principles of similar effect.
8. ENFORCEABILITY. The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or
enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.

I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY ELECTRONICALLY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.

Affirmation of Understanding of Travel Expenses(Required)

By clicking here I affirm I have read and understand the travel expenses I am responsible for.

By clicking here you acknowledge that you are responsible for travel arrangements to arrive at the Mandalay Bay Hotel, Las Vegas, NV by the start of the retreat July 6, 2026 and depart July 10, 2026. Incidental expenses are the participants responsibility.