PLEASE READ THIS DOCUMENT CAREFULLY AS IT AFFECTS YOUR FUTURE LEGAL RIGHTS & PROVIDE YOUR INTITALS ON EACH LINE AFTER READING
As used herein, the term “Releasees” is defined to include: (i) 5K THE NEWBURY WAY (“Event”), its owners, members, directors, officers, past and present employees, agents, representatives, affiliated companies, successors and assigns; (ii) Event volunteers; (iii) the owner of the property where the Event occurs, including (where applicable) any city, county, and/or state government(s); and (iv) any Event sponsors or advertisers each of their respective owners, members, directors, officers, past and present employees, agents, representatives, affiliated companies, successors and assigns.
____ 1. I understand that participating in the Event involves the risk of severe physical injury and/or death that cannot be completely eliminated.
____ 2. I voluntarily, knowingly and freely assume all risks associated with competing in the Event, including, but not limited to, my own actions or inactions, the actions or inactions of others (including participants, spectators, and Releasees), falls, injuries, illnesses, infections, contact with others, completing any and all obstacles, premises defects and the effects of weather, including but not limited to, heat and/or humidity.
____ 3. I certify that I am physically fit and have no medical condition that would make participation in the Event more hazardous.
____ 4. I attest that on the date of the Event I will possess and be covered by medical insurance, individually or as part of an organization.
____ 5. I consent to medical care and transportation in order to obtain treatment in the event of injury to me as 5K THE NEWBURY WAY(event) volunteers or medical professionals may deem appropriate and understand that this Waiver extends to any liability arising out of or in any way connected with such medical treatment and transportation provided in the event of an emergency and/or injury.
____ 6. I agree to observe and obey all posted rules and warnings, to follow any instructions or directions given by the 5K THE NEWBURY WAY (event) through its employees, representatives or agents, and to abide by any decision of any Event official relative to my ability to safely attend and participate in the Event.
____ 7. I understand and agree that I am expected to exhibit appropriate behavior and to obey all local, state, and federal civil and criminal laws at all times while participating in or attending the Event. This includes, generally, respect for all people, equipment, facilities or property. 5K THE NEWBURY WAY (event) volunteers and staff may dismiss me, without refund, should my behavior endanger the safety of or negatively affect the Event, person, facility or property and I agree to indemnify the Release’s from any and all third party claims caused in whole or in part by my negligence, gross negligence or intentional acts or omissions.
____ 8. I agree that the 5K THE NEWBURY WAY (event) is not responsible for any personal item or property that is lost, damaged, or stolen at the Event.
____ 9. I consent to the use of my image in photographs, motions pictures or recordings taken at the Event for use in Event advertising, marketing or promotion.
____ 10. I assign all rights, title, and interest in any and all photographs, motion pictures, recordings or other records of the Event I may take or capture to the 5K THE NEWBURY WAY (event). 5K THE NEWBURY WAY(event) grants to me a limited, non-exclusive, perpetual right and license to use, for non-commercial purposes only, any and all photographs, motion pictures, recordings, or other records of the Event that I may take or capture.
____ 11. I agree that all entry fee payments are final and non-refundable.
____ 12. I agree that the 5K THE NEWBURY WAY (event) reserves the right to cancel the Event in the event of weather (including, but not limited to, heat, tornadoes, earthquakes, fires, storms, lightning and floods), accidents, acts of war or terrorism, military conflicts or riots or for any reason that, in the 5K THE NEWBURY WAY (event’s) discretion, will protect the safety and security of
Event participants and spectators. In the event of such cancellation, there will be no refund of my registration fee.
See reverse side
____ I am at least 18 years old OR
MY DATE OF BIRTH IS (MM/DD/YYYY) ______/______/_________
____ I acknowledge that I have read and fully understood the important information above, that I have carefully analyzed, accepted, and agree to all terms herein, that I
sign on my own free act and deed that I understand that I have given up legal rights by signing below.
____ I acknowledge that this Waiver is consideration for permission to participate in the Event and my participation in the Event WILL BE DENIED if my signature (or the signature of my parent/guardian if I am under the age of 18) does not appear on this Waiver prior to my participation in the Event.
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First and Last Name (PRINTED) Name (SIGNED) Date
ONLY COMPLETE SECTION BELOW IF YOU ARE THE PARENT OR GUARDIAN OF A PARTICIPANT UNDER THE AGE OF 18
I, the parent or guardian of the above named participant (“Minor”), gives my approval for Minor’s participation in the Event. I assume all risks and hazards incidental to Minor’s participation in the Event and I release, waive, discharge, absolve, indemnify, agree to hold harmless and covenant not to sue the Release’s for any claim arising out of an injury to the Minor and from any and all claims, causes of action, obligations, lawsuits, charges, complaints, controversies, damages, costs or expenses of any kind, nature, or description, whether direct or indirect, in law or in equity, in contract or in tort, or otherwise, whether known or unknown, arising out of or connected with Minor’s attendance at and participation in the Event, whether or
not caused by the Release’s’ negligence or gross negligence. I consent to the foregoing, grant permission for minor to participate in the Event and acknowledge that I have carefully analyzed, accepted and agreed to the terms of this Waiver, know and understand its contents and sign the below on my own free act and deed.
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First and Last Name (PRINTED) Name (SIGNED) Date
Thank you for your support and participation