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No emails or URLs allowed

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PARTICIPATION WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT
In consideration of the acceptance of this entry, I, the undersigned, intending to be legally bound, hereby for myself, my heirs, next of kin, executors, administrators, personal representatives, successors and assigns, do forever waive, release and discharge, and agree to hold harmless and indemnify, the SOUTH SALEM PRESBYTERIAN CHURCH and/or its directors, officers, employees, members and operators (including Memorial Day volunteers, vendors, Super Race Systems, sponsors and their representatives) of and from any and all liability, claims, actions and possible causes of action (including negligence), damages or injuries (including personal injury, death or property damage) whatsoever, that may be sustained by me and my property arising out of or related to my participation in the South Salem Memorial Day Races and activities. I attest and verify that I will participate in this event as a foot race entrant, that I realize there are risks associated with my participation in this event, that I assume all such risks, that I am physically fit, and that a licensed Medical Doctor has verified my physical condition. Further, I hereby grant full permission to any and all of the foregoing released persons to use photographs, videotapes, motion pictures, recordings, or any other record of my participation in this event for any legitimate purpose.   Participant’s Signature: I HAVE READ, UNDERSTAND AND ACCEPT THE FOREGOING.    In consideration of the acceptance of this entry, I, the undersigned, intending to be legally bound, hereby for myself, for my child (named below), and for my and my child’s heirs, next of kin, executors, administrators, personal representatives, successors and assigns, do forever waive, release and discharge, and agree to hold harmless and indemnify, the SOUTH SALEM PRESBYTERIAN CHURCH and/or its directors, officers, employees, members and operators (including Memorial Day volunteers, vendors, sponsors and their representatives) of and from any and all liability, claims, actions and possible causes of action (including negligence), damages or injuries (including personal injury, death or property damage) whatsoever, that may be sustained by me or my child and our property arising out of or related to my and/or my child’s participation in the South Salem Memorial Day Races and activities. I attest and verify that I and/or my child will participate in this event as foot race entrant(s), that we realize there are risks associated with my and/or my child’s participation in this event, that we assume all such risks, that I and my child are physically fit, and that a licensed Medical Doctor has verified my and my child’s physical condition. Further, I hereby grant full permission to any and all of the foregoing released persons to use photographs, videotapes, motion pictures, recordings, or any other record of my and/or my child’s participation in this event for any legitimate purpose.   The foregoing is signed on behalf of each child named below. I hereby certify that I am a custodial parent or legal guardian of the child or children named below and have all necessary right and authority to sign this agreement on behalf of such child or children.

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First 300 Registrants Receive T-Shirts
First 200 Pee Wee Registrants Receive T-Shirts


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Your contribution is greatly appreciated and will help The Forever Molly and Gregory Fund support the pursuits closest to Molly and Gregory's hearts in the areas of academic, athletic and artistic achievement in the Lewisboro community.


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Get your friends to join you
Have {{entryReferralData.goal}} friends sign up using the link below to receive {{entryReferralData.award | currency:"$"}}
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