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Participant Assumption of Risk and Waiver or Claims.

I acknowledge that participating in the Party in Pink 5K Run/Walk of the Kids Fun Run Even is a potentially hazardous activity. I will not participate unless i am medically able to do so, am properly trained and have the resources to cover the medical cost for injuries that may occur. I assume responsibility for the risks associated with participation in this event, including accidental injury of death resulting from falls, contact with other runners or accidents.  I will pay my own medical expenses in the event of accidents, illness or incapacity and will not hold the Survivors of benton Country/VGH Healthcare Foundation responsible for those expenses of other losses I or my family incur if I am injured. I waive any and all additional notice of the existence of dangerous conditions associated with the race and course and assume responsibility to exercise my own judgement in evaluating there conditions.

With knowledge of these facets, and in consideration of the acceptance of this entry application, I , for myself, my heirs and anyone active in my behalf in my place or on my behalf. discharge and release The Survivors of Benton Country/VGH Healthcare Foundation from any and all claims and actions at law for damages or monetary awards arising out of my participation in the Party in Pink 5K Walk/Run Event including injury to my person or property caused by and act or failure to act by the above entities and person.  By signing my name below, I intend to be legally bound by all the terms and conditions of this assumption of risk and waiver or claims.

Furthermore, I grant permission to The Survivors of Benton Country/VGH Healthcare Foundation to use any photographs or any record of this event for legitimate purposes. I understand that the entry fees are non-refundable.

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The Survivors of Benton Country will be donating all of the proceeds of the 5K to GIFTS OF HOPE, a program created to provide mammograms and other services to women who cannot afford the breast cancer detection and other procedures.

The program pays for mammograms performed in the Virginia Gay Hospital Imaging Department, mammogram interpretation in Radiology Consultants of Iowa, PLC, and the clinic visit to set up the mammogram.

For more information about GIFTS OF HOPE, contact your medical provider or Lynette Bakenhus at Virginia Gay Hospital, 502 N. 9th Ave., Vinton, IA 52349 or by phone 319-471-6256.


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