Walk it Off Liz & Reilly Walk Waiver and Release
PARTICIPANT’S NAME: ______________________________________
PARTICIPANT’S EMAIL ADDRESS: _______________________________________________________________________________
IF PARTICIPANT IS A MINOR (UNDER 18 YEARS OF AGE) STATE NAME OF PARENT OR GUARDIAN: _________________________
IMPORTANT INFORMATION AND WARNING OF RISK
94-5 MIX FM and event partners are committed to conducting this weekly walk/run program in a safe manner and holds the safety of participants in high regard. Participants and parents/guardians of minors registering for this activity must recognize that there is an inherent risk of injury when choosing to participate in running/walking events.
You (the “Participant”) are solely responsible for determining if you or your minor child/ward is physically fit and/or adequately skilled for weekly walk/run participation. It is always advisable, especially if the Participant is pregnant, disabled in any way, or recently suffered an illness, injury, or impairment, to consult a physician before undertaking any physical activity. You are also solely responsible for selecting and wearing personal protective equipment. Most important, remember that this is a voluntary recreational activity.
Not all hazards and dangers can be foreseen, there is a risk of serious injury, including death. Walking can be hazardous and risky, including but not limited to overexertion, dehydration, slip and falls, collisions with other participants, the effects of weather, dangerous conditions of the road, being struck by a vehicle or bicycle, lack of good physical conditioning, poor training technique, and all other circumstances inherent in running/walking events. In this regard, it must be recognized that it is impossible for 94-5 MIX FM and event partners to guarantee absolute safety.
WAIVER AND RELEASE OF ALL CALIMS AND ASSUMPTION OF RISK
Please read this form carefully and be aware that in signing up and participating in this event, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss, including death, which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this Run/Walk Event.
I recognize and acknowledge that there are certain risks of physical injury to participants in this event, and I voluntarily agree, as a condition of my and/or my minor child’s participation in the Run/Walk Event, to assume the full risk of any injuries, costs, damages or losses, regardless of severity, that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with this Run/Walk Event.
I agree to waive and relinquish all claims, specifically including those for any injury (including death), costs, damages and/or losses arising out of or otherwise incidental to participation in the Run/Walk Event, that I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this activity, against the 94-5 MIX FM and event partners including its sponsors, officers, officials, agents, employees, representatives, volunteers and servants, (both individually and collectively) (hereinafter collectively referred to as “94-5 MIX FM”). On behalf of myself and/or the minor identified above, and on behalf of my or my minor’s respective heirs, executors, administrators, and assigns, I do hereby fully release and forever discharge 94-5 MIX FM from and against any and all claims for injuries, damages or loss, including death, that my minor child/ward or I may have or which may accrue to me or my minor child/ward, and arising out of, connected with, or in any way associated with this Run/Walk Event. This waiver and release shall apply to any and all actions, causes, damages, claims, or demands of every kind, whether known or unknown, arising out of or otherwise incidental to participation in the Run/Walk Event. On behalf of myself and/or the minor identified above, I hereby agree to indemnify, hold harmless, and defend 94-5 MIX FM from and against any and all liability or claims for loss, damage, or injury to person or property, or of any other kind, whether known or unknown, including the Participant’s person and property and including claims for attorney’s fees, arising out of or otherwise incidental to Participant’s participation in the Run/Walk Event.
While participating in the Run/Walk Event, I agree to obey all rules, regulations, and laws of the United States, its subdivisions, and the locations visited. I agree to obey all rules, regulations and policies of 94-5 MIX FM and event partners, including any Rules issued with respect to the Run/Walk Event and/or any institutions or organizations associated therewith. I agree that my violation of the above rules, regulations, laws or policies (as determined in the sole discretion of any 94-5 MIX FM representative) may result in my immediate expulsion from the Run/Walk Event. I further agree that this Waiver and Release shall be governed by the State of Oregon.
I have read and fully understand the above “Important Information and Warning of Risk”, “Waiver and Release of All Claims and Assumption of Risk”, and their indemnification provisions. Participant represents that she/he is executing this agreement voluntarily.
Participant’s Signature (18 years or older; or Parent/Guardian) ____________________________________________Date _________________
Emergency Contact Information: Name____________________________________________ Phone: ___________________________