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EVENT WAIVER FORM (Signature Required)

In consideration of acceptance of this entry, I hereby, for myself, my heirs, my executors, administrators and anyone entitled to act on my behalf, waive and release the Concerns of Police Survivors (C.O.P.S.) Arizona Chapter, the Arizona Peace Officer’s Memorial Charity Inc., sponsors, the City of Phoenix, Raceplace Event Systems, USA Track & Field, coordinating groups, directors, agents, volunteers, any governmental bodies or locations in which the event is held, from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

I certify that I am in good physical condition/health and capable of participating in this event.   I assume all risks associated with this event including, but not limited to:  falls, contact with other participants, the effects of weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. 

I understand that none of the above are responsible for the loss of neither personal items nor any other form of aggravation in connection with said event.

I acknowledge that I am an amateur in such events.  

I grant permission for free use of my name and picture or any other record of this event in any broadcast, telecast or print media account of this event.

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This fundraiser is hosted and benefits the Concerns of Police Survivors (C.O.P.S.) Arizona and the Arizona Peace Officers Memorial Charity, Inc.  Proceeds from the event help rebuild the lives of fallen police officer families and for maintenance of Arizona’s memorial.

Show your support for C.O.P.S. Arizona by purchasing our specialty license plate for your vehicle. C.O.P.S. Arizona receives $17 annually for each license plate purchased and they are available to everyone. Purchasing our license plate demonstrates your commitment to assisting in the healing of family and co-workers of Arizona’s law enforcement officers killed in the line of duty. To order a C.O.P.S. Arizona specialty plate, visit ServiceArizona.com.


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