ASSUMPTION OF RISK,
WAIVER OF LIABILITY, RELEASE OF CLAIMS, INDEMNITY, AND CONSENT TO MEDICAL
TREATMENT AGREEMENT (“WAIVER”)
PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING AS
THIS DOCUMENT HAS LEGAL CONSEQUENCES AND WILL AFFECT YOUR FUTURE LEGAL RIGHTS
AND WILL ELIMINATE YOUR ABILITY TO BRING FUTURE LEGAL ACTIONS. PLEASE PROVIDE
YOUR INTIALS ON EACH LINE AFTER READING.
Parties: “Released Parties” Merlin Entertainments Group Florida,
LLC, db a LEGOLAND Florida Resort, and its past
or present directors, officers, employees, agents, representatives, contractors,
consultants, insures, spectators, equipment suppliers, and volunteers; and any
or all parent, subsidiary. Or affiliate companies (whether by contract or
ownership), licensees, officers, directors, partners, board members, supervisors,
insurers, agents, equipment suppliers, and representatives of any of the
foregoing; include Polk County Board of County Commissioners, and its past or
present officials, employees, agents, representatives, contractors,
consultants, insurers, spectators, affiliates, and volunteers.
“Releasing Parties” include the Participant as well as Participant’s spouse, children,
parents, guardians, heirs, next of kin, and any legal or personal
representatives, executors, administrators, successors, and assigns, and anyone
else who might claim or sue on Participant’s behalf.
Inherent Risks: “Inherent Risks” are risks that cannot be eliminated
completely (without changing the nature of the Event) regardless of the care
and precautions taken by the Released parties. Inherent Risks include, but are
not limited to, contact or collision with persons or objects, contact with
other participants, contact with natural or manmade fixed objects;
weather-related hazards such as extreme heat or cold, humidity or rain, or fog;
and judgement and or behavioral related problems such as erratic or
inappropriate co-participant behavior.
1. I understand
that participating in the Brick Dash 5K (“Event”)
involves the risk of physical or mental injury and or death that cannot be
1. I certify that I am physically fit and
have no medical condition that would make participation in the Events hazardous
3. If I am
pregnant, disabled, in any way or have recently suffers an illness or injury. I
have consulted a physician before participating in the Event and have been
authorized by a physician in writing to participate in the Event.
4. I attest
that on the date of the Event I will possess and be covered by medical
insurance, individually or as part of an organization, in amounts adequate to
pay for any injury that I may sustain.
5. If I should
suffer illness or injury, I consent to any and all medical care and
transportation in order to obtain treatment as the Released Parties,
volunteers, medical professionals, and other employees and agents may deem
appropriate in their discretion. I understand that this Waiver extends to any
liability arising out of or in any way connected with such medical treatment
and transportation provided in the event of an emergency and or injury. I
further understand that I assume the direct responsibility for payment of any
and all costs or fees of medical treatment and transportation.
6. I agree to
observe and obey all posted rules, warning, to follow any instructions or
directions given by the Releases Parties through its employees,
representatives, or agents, and abide by any decision of any event Official
relative to my ability to safely attend and participate in the Event.
7. I understand
and agree that I am expected to exhibit appropriate behavior and to obey all
local, state, and federal civil and criminal laws at all times while
participating in or attending the Event. This included generally, respect for
all people, equipment, facilities, or property. The Releases Parties may
dismiss me and or eject me from the event without refund, should my behavior
endanger the safety of or negatively affect the Event, person, facility, or
property and I agree to indemnify the released Parties from any and all third
party claims caused in whole or in part by my negligence, gross negligence, or
intentional acts or omissions.
consideration of being permitted to participate in the Event, I (on behalf of
the releasing Parties) agree to forever waive, release, covenant not to sue,
and discharge the Released Parties from any and all claims resulting from the
Inherent Risks of the Event, even though that liability may arise out of the
negligence or carelessness on my part of the part or the part of the Released
Parties, and any and all other claims that I may have arising out of my
participation in the Event, including but not limited to personal injury
(including death) from incidents or illnesses arising from the event
participation, including but not limited to injuries dr9ing course inspection,
observation, practice runs, and while on premises; and any and all claims
resulting from damage to, loss of, or theft or property.
9. I consent to
the use of my image in photographs, motion pictures, recording, and or any
other record taken at the Event for any purposes of the Event whatsoever.
10. I agree
that all event registration fee payments are final and non-refundable.
11. I agree
that the Released Parties reserve the right to cancel the event in the event of
weather, accidents, acts of war or terrorism, military conflicts, or riots, or
for any reason that, in Released Parties’ sole discretion, will protect the
safety and security of Event participants and spectators. In the event of such cancellation
there will be no refund of my registration payment.
12. I agree the
Waiver is intended to be as broad and inclusive as permitted by the laws of the
State of Florida and that if any portion is held invalid, the balance shall
continue in full legal force and effect.
understand and acknowledge that the laws of the State of Florida shall apply to
all matters relating to this waiver,
that she exclusive jurisdiction for any dispute with the Releasing Parties
resides in state or federal court of Polk County, Florida and I
consent to the exercise of personal jurisdiction in the State of Florida in
connection with any dispute with the Releasing Parties arising from my Event:
attendance or participation.
14. (Check One) I
am at least 18 years old OR I am at 14 years old and my Parent
Guardian has reviewed this Waiver and consented to its terms. MY DATE OF BIRTH IS (MM/DD/YYYY) / / . (We can probably modify this within the
system so we probably don’t need this one.)
In addition to the foregoing, I recognize, acknowledge,
and understand that there are inherent risks of severe physical injury and or
death when participating in the event. I am solely responsible for determining
if I am (or my minor child/ward is physically fit and sufficiently skilled for
the Event. I freely and voluntarily agree to assume the full risk of any and
all injuries, liabilities, damages, costs or losses, regardless of severity,
that I (or my child/ward) may sustain as a result of participating or attending
the Event. I release waive, discharge, absolve, indemnify agree to hold harmless,
and covenant not to sue the Released Parties, for any claim arising out of any
injury to me (or my child Ward) and from any and all claims, causes of action.
Obligations, lawsuits, charges, companies, controversies, damages, costs, or
expenses of any kind nature or description, whether direct or indirect, in law
or in equity, in contract or in tort, or otherwise, whether known or unknown,
arising out of or in connection with my (or my child’s/ward’s) attendance at
and participation in the Event whether or not caused by the Releases Parties’
negligence gross negligence or international conduct.
I acknowledge that I have been afforded the opportunity
prior to the Event to read the important information above.
I acknowledge that I have read and fully understood the
important information above, that I have carefully read, analyzed, understood,
accepted, and agreed to all terms herein, that I sign on my own free act and
deed, and that I understand that I have given up legal rights by signing below.
I acknowledge that this Waiver is consideration for
permission to participate in the Event and my
participation in the Event WILL BE DENIED if my signature (or signature
of my parent/guardian if I am under the age of 18) does not appear on this
Waiver prior to my participation in the Event.
FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE
IN A POENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE RELEASED
PARTIES USE RESONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR
CHILD MAY BE SERIOULSY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY
BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE
AVOIDED OR ELIMINATED BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT
AND YOUR RIGHT TO RECOVER FROM THE RELEASED PARTIES IN A LAWSUIT FOR ANY
PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT
RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE
RIGHT TO REFUSE TO SIGN THIS FORM, AND THE RELEASE PARTIES HAVE THE RIGHT TO
REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.