Individual Tickets

Package Name

Amount

Quantity

Subtotal

Individual Ticket(s)

$100.00

$0.00

If you are physically attending the event, you agree to the following terms:

I agree to participate in the Southern Illinois Healthcare Gala sponsored by Southern Illinois Hospital Services ("SIHS") and SIH Foundation ("SIHF"). I hereby acknowledge that attending and participating in the Gala it is entirely voluntary. I hereby acknowledge participation includes possible exposure to and illness from infectious diseases including but not limited to COVID-19. I knowingly and freely assume all such risks related to illness and infectious diseases, such as COVID-19, even if arising from the negligence or fault of SIHS.

I hereby release, waive and forever discharge any and all liability, claims, and demands of whatever kind or nature against SIHS and its affiliated partners and sponsors, including in each case, without limitation, their directors, officers, employees, volunteers, and agents (the "released parties"), either in law or in equity, to the fullest extent permissible by law, including but not limited to damages or losses caused by the negligence, fault or conduct of any kind on the part of the released parties, including but not limited to death, bodily injury, illness, economic loss or out of pocket expenses, or loss or damage to property, which I, my heirs, assignees, next of kin and/or legally appointed or designated representatives, may have or which may hereinafter accrue on my behalf, which arise or may hereafter arise from my participation with the activity.

By participating in the event, you are stating that you have carefully read the foregoing Waiver and Release of Liability, know the contents thereof, and agree to this Waiver and Release of Liability as your own free act and deed.

I would like to make an additional donation.

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I would like to make an additional donation.

THANK YOU SPONSORS! (click on logo/name to visit website)

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