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{{ 'FIRST-NAME' | translate}}

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No emails or URLs allowed

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No emails or URLs allowed

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Accident Waiver and Release of Liability I hereby acknowledge that this athletic event is an extreme test of a person’s physical and mental limits and is an inherently dangerous activity and carries with it the potential for death, disability, serious injury, and bodily harm. The risks include, but are in no way limited to, those caused by terrain, temperature, weather, vehicular traffic, unknown hazards, actions of other people including but not limited to, other participants, coaches, event officials, event monitors, volunteers, lack of hydration, and or the event producer. These risks are not only inherent to participating athletes, but are also present for volunteers.
I hereby assume all of the risks associated with and attendant to participating in this event. I certify that I am physically fit, am sufficiently trained and have prepared for participation in this activity and have not been advised otherwise by a qualified medical person that I cannot or should not participate.  I acknowledge that this Accident Waiver and Release of Liability form is being used by Central National Bank and Flinthills Breadbasket, Inc., and that it will govern my actions and responsibility during and after this event.                 In consideration of my participation in this activity, I, hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as allows: A) Waive, release and discharge Central National Bank and Flinthills Breadbasket, Inc., and each of them, and their successors, predecessors, assigns, heirs, administrators, executors and agents, subsidiaries, parent corporations, together with their respective agents, insurers and reinsurers (whether primary, excess or otherwise), servants, employees, officers, directors, attorneys and representatives, and any other person or entity that is involved with, or connected to either of them, from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me from this physical activity; B) Indemnify and hold harmless Central National Bank and Flinthills Breadbasket, Inc., and each of them, and their successors, predecessors, assigns, heirs, administrators, executors and agents, subsidiaries, parent corporations, together with their respective agents, insurers and reinsurers (whether primary, excess or otherwise), servants, employees, officers, directors, attorneys and representatives, and any other person or entity that is involved with, or connected to either of them, as a result of my reckless or negligent actions or any other actions during or after this physical activity. 
I hereby: 
1.  Acknowledge that I am familiar with the sport of running and understand the requirement to act with extreme care and caution when participating in athletic events and fully understand the risk involved. 
2.  Agree that prior to participating or engaging in this activity I have the ability to fully inspect the course, terrain, and general surroundings, and believe if anything is unsafe or beyond my ability, I will immediately refuse to participate or engage in this event. 
3.  Acknowledge and fully understand that I will be engaging in a dangerous environment that might result in serious injury; including permanent disability or death, and severe social and economic losses due not only to my own actions, inactions, or negligence, but also the inaction, or negligence of other participants, and Central National Bank and Flinthills Breadbasket, Inc., and both of their representatives, directors, officers, and agents.  Further, I acknowledge that there may be other risks not known to me or reasonably foreseeable at this time.
4.  Acknowledge knowing the risks involved in running and related physical activities, I assume said risk and accept personal responsibility for the damages following any injury, permanent disability or death based on my participating in this event. 
5.  Release, waive and discharge and covenant not to sue Central National Bank and Flinthills Breadbasket, Inc., or any of their successors, predecessors, assigns, heirs, administrators, executors and agents, subsidiaries, parent corporations, together with their respective agents, insurers and reinsurers (whether primary, excess or otherwise), servants, employees, officers, directors, attorneys and representatives from any and all claims, demands, losses, or damages on account of injury, including permanent injury and death or damage to property, caused or alleged to be caused in whole or in part by the negligence of other participants, Central National Bank or Flinthills Breadbasket, Inc., or either of their respective agents, officers, directors, attorneys, representatives, or otherwise.
This Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under Kansas law or any other applicable body of law. I hereby certify that I have read this document and I understand its contents, and fully understand that by signing this form, I am giving up legal rights and/or remedies which may be available to me. 
 
PARENT OR GUARDIANS FOR MINORS(UNDER 18 YEARS OF AGE)               
The undersigned parent and/or natural guardian or legal guardian of _______________________, does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify Central National Bank and  Flinthills Breadbasket, Inc. from all liability, loss, cost, claim or damage whatsoever which may be imposed upon Central National Bank and/or Flinthills Breadbasket, Inc. or any of their successors, predecessors, assigns, heirs, administrators, executors and agents, subsidiaries, parent corporations, together with their respective agents, insurers and reinsurers (whether primary, excess or otherwise), servants, employees, officers, directors, attorneys and representatives because of any defect in or lack of such capacity to so act and release Central National Bank and Flinthills Breadbasket, Inc. on behalf of the minor and the parents or legal guardian. No Refunds after June 1st.

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{{ 'SUBTOTAL' | translate}} : {{cart.subtotal | currency:"$":currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$":currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.fee | currency:"$":currency.decimal}}
{{ 'SALES_FEE' | translate}} : {{cart.totalSales | currency:"$":currency.decimal}}
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{{ 'PROCESSING_FEE' | translate }} : {{cart.lotteryFee | currency:"$":currency.decimal}}
{{ 'TOTAL_CHARGE_IF_SELECTED' | translate}} : {{cart.lotteryTotal | currency:"$": currency.decimal}}
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{{ 'OR' | translate }}

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{{ 'REQUIRED' | translate }} {{ 'PAYMENT-NAME-MIN-LENGTH' | translate }}

{{ 'CARD-NUMBER' | translate }}
{{ 'EXPIRATION' | translate }}
{{ 'SECURITY-CODE' | translate }}
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{{ 'REGION' | translate }}

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{{ 'REQUIRED' | translate }} {{ 'INVALID-CREDIT-CARD-NUMBER' | translate }}

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