Mighty Gobbler 5k and 1 Mile Fun Run/Walk
Lutheran Church of the Master
By indicating your acceptance, you
understand, agree, warrant and covenant as follows:
I acknowledge that this athletic event
is an extreme test of a persons 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 athlete, lack of
hydration, equipment, vehicular traffic, and actions of other people, including
but not limited to,
participants, volunteers, spectators,
and event officials. I hereby assume all risks of participation in this event.
I acknowledge that thisAccident Waiver and Release of Liability (AWRL) form will
be used by the event director, partners and event sponsors, and that itwill
govern my actions and responsibilities at said event(s).
I realize that liability may arise from
negligence or carelessness on the part of the persons or entities being released,
from dangerous ordefective equipment, 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
qualified medical personnel.In
consideration of my application and permitting me to participate in this event,
I hereby take action for myself, my executors,administrators, heirs, next of
kin, successors, and assigns as follows: (A) waive, release, and discharge from
any and all liability formy death, disability, personal injury, property
damage, property theft or actions of any kind which may hereafter accrue to
meincluding my travelling to and from this event. The following entities or
persons; endurance event directors association (EEDA), High Five Races, its
Staff, Volunteers, Partners, Sponsors, and all municipal agencies whose
property and/or personnel are used, and othersponsoring and co-sponsoring
company(s), agency(s), or individual(s) including but not limited to Lutheran
Church of the Master, The City of Troy, Michigan, Troy Ventures LLC and
Somerset Collection Limited Partnership (B) Indemnify and hold harmless the
entities or personsmentioned in this paragraph from any and all liabilities or
claims made as a result or participation in this event, whether caused by
thenegligence 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 duringthis 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 usedfor any legitimate purpose by the event holders, sponsors,
and/or assigns. I ALSO UNDERSTAND THAT THE ENTRY FEE ISNON-REFUNDABLE AND ONLY
TRANSFERABLE UNTIL NOV 1ST. If my check or credit card payment for this event
does not go through and High Five Races, LLC or other organization is charged a
fee from the bank, than I am responsible for the event fee I attempted to pay
and a $25charge. I have read and understand the rules for this event and I
hereby acknowledge and abide by these rules. This AWRL shall be construed
broadly to provide a release and waiver to the maximum extent permissible under
applicable law. As aparticipating athlete, I certify that all the information
provided on my race entry form is true and complete. I have read the
pre-raceinformation and this AWRL, and certify my compliance by my signature
below.PARENT GUARDIAN WAIVER FOR MINORS (LESS THAN 18 YRS OLD)The undersigned
parent and natural guardian or legal guardian does hereby represent that he/she
is, in fact, acting in such capacity andagrees to save, hold harmless and
indemnify each and all parties referred to above from any and all liability,
loss, claim or damagewhatsoever made as a result of participation in this
event. I further certify that the athlete is in good physical condition, and
that eventofficials have my permission to authorize emergency medical
treatment, if necessary. I certify that the information provided on therace
entry form is true and complete. I have read the pre-race information and this
AWRL, and certify compliance by my signaturebelow.
BY INDICATING YOUR ACCEPTANCE OF THIS
AGREEEMENT AND WAIVER, YOU ARE AFFIRMING THAT YOU
HAVE READ AND UNDERSTAND THIS AGREEMENT
AND WAIVER AND FULLY UNDERSTAND ITS TERMS. YOU
UNDERSTAND THAT YOU ARE GIVING UP
SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. YOU
ACKNOWLEDGE THAT YOU ARE SIGNING THE
AGREEMENT AND WAIVER FREELY AND VOLUNTARILY, AND
INTEND BY YOUR ACCEPTANCE TO BE A
COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE
GREATEST EXTENT ALLOWED BY LAW.
PHOTO RELEASE
I hereby grant High Five Races
permission to use my likeness in a photograph or video in any and all of its
publications, including
website entries, without payment or any
other consideration. I understand and agree that these materials will become
the property of
High Five Races.
I hereby irrevocably authorize High
Five Races to edit, alter, copy, exhibit, publish or distribute this photo or
video for purposes of
publicizingHigh Five Races’s programs
or for any other lawful purpose. In addition, I waive the right to inspect or
approve the finishedproduct, including written or electronic copy, wherein my likeness
appears. Additionally, I waive any right to royalties or othercompensation
arising or related to the use of the photograph. I hereby hold harmless and
release and forever discharge High Five Racesfrom all claims, demands, and
causes of action which I, my heirs, representatives, executors, administrators,
or any other personsacting on my behalf or on behalf of my estate have or may
have by reason of this authorization.
By signing below, I agree to the above
waiver
Signature:
Date:
If under 18 years of age, signature of
parent or guardian: