I, ________________________, with an address of
__________________________________________, individually (or as a Parent or
Guardian of _________________________, a Minor) have registered to participate in the
2018 Hoof n’ Sloshin 2.5 mile or 500 meter race (the EVENT) which is scheduled for
August 11, 2018.
I certify that I am aware of the potential dangers and risks associated with participation in the
EVENT, including but not limited to: collisions and falls, illness, infection, premises defects,
dangerous conditions of any property, facilities, or equipment used during the Event, variations
in the terrain, impact or collision with exposed rock, earth, trees, other natural and manmade
objects, other participants, event staff, spectators, and obstacles; changing weather conditions;
negligence of other participants and; negligence on the part of Mt. Holiday, the EVENT
sponsor, the property owners, and their agents, officers, directors, employees, volunteers,
insurers, venue, sponsors, contractors and assigns, and all persons/companies officially
connected with the EVENT; any of which may result in personal injuries including paralysis,
brain damage and death and property damage.
I voluntarily accept and assume all risks in connection therewith, including risks resulting from
my own actions as well as the actions of others, including, but not limited to, other participants,
event staff and spectators. In consideration of being allowed to participate in the EVENT, I
HEREBY EXPRESSLY AGREE TO ASSUME THE RISKS AND WAIVE ALL CLAIMS
THAT I AND/OR THE MINOR HAVE OR MAY HAVE IN THE FUTURE RELATED TO
PARTICIPATING IN OR PRESENCE AT THE EVENT.
What I Agree to Pay For - If any Releasee is sued or has to pay anyone else because of my
conduct, I will reimburse them for all their legal costs, fees and payments.
My Health; Permission to Get Medical Help - I do not know of any personal health
condition that would get worse if I participate in the Race. I authorize the race volunteers and
staff to get emergency medical treatment for me during the Race.
Photo Release - I grant Mt. Holiday permission to use any photo or video in which I appear
individually or in a group for purposes of promotion, advertising, product sales or posting on
its web site.
Severability - If any provision, or portion thereof, of this waiver agreement is, or becomes,
invalid under any applicable statute or rule of law, it is to be deemed stricken and the rest of
this agreement shall remain in full force and effect.
I HAVE CAREFULLY READ AND UNDERSTOOD THIS RELEASE OF LIABILITY
AND INDEMNITY AGREEMENT and voluntarily agree to its terms. I am aware that by
signing this document, I am waiving substantial legal rights on my own behalf (or the
Minor’s), and on behalf of my (or the Minor’s) estate, heirs, executers and next of kin,
including giving up the right to sue. Please check one of the following, then sign and date
where indicated:
______I further state that I am 18 years of age or older and legally competent to sign this
Release and that I have signed this document of my own free act.
______I am a minor under the age of 18 and the undersigned is my parent or guardian
and has signed this Release on my behalf.
_____________________ ____________________________ ______________
Name of Participant If participant is a minor, Name of Date
(Please Print) Parent or Guardian (Please Print)
_____________________________________ ________________________________
Signature of Participant or Parent/Guardian Phone Number of Participant or
if participant is a minor Parent/Guardian if participant is a minor
