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little a triathlon  
Participant Waiver    
Event Date: 6/24/17  
I acknowledge that this athletic event is an extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to athletics, but are also present for volunteers. I hereby assume all risks of participating and/or volunteering in this event. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them or because of their possible liability without fault. I certify that I am physically fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person. I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors and organizers, in which I may participate and that it will govern my actions and responsibilities at said events. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, next of kin, successors, and assigns as follows: (A) Waive, Release, and Discharge 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 including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: little a triathlon directors, volunteers participants and any official or other entity associated with the Event their directors, officers, employees, volunteers, representatives, and agents, the event holders, event sponsors, event volunteers: (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this event, whether caused by the negligence of releases or otherwise. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and/or illness during this event. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers and assigns. The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I hereby certify that I have read this document; and I understand it’s content. I release the event, directors, and any entities associated with the event from injury occurring during or as a result of actions taken during the post-event gathering.
 
PARENT GUARDIAN WAIVER FOR MINORS (UNDER 18 YEARS OLD). The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian. Guardian must sign below if participant is under 18 years old.  
 
I am over the age of 18 and have carefully read and understand the contents of this Waiver and Release.

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To add team members: At the Checkout Summary screen click the ADD NEW ENTRY button, select the Relay option, and add your team members using SAME TEAM NAME to avoid an additional fee.

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Natilynn was diagnosed with leukemia July 10, 2016. She turned 4 (in the hospital) on Sept 22. She will receive chemotherapy for about 2 1/2 years. The 5 year survival rate for her cancer is anywhere from 80-95%. Before she got sick you could find her outside climbing trees in a princess dress or zooming around the sidewalk on her scooter. She rarely complains about a thing aside from her tummy being sick or her legs hurting her. She has 3 brothers and 6 sisters, 5 of them are still at home with her. 
 
Funds raised from this event will go to Natilynn Matos and her family.  Natilynn’s story can be found on the race website or on her Facebook Page   

Tax ID is 81-4635237


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