48th Annual Freedom Run 10K, 5K and 1 Mile

In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors and administrators, waive any and all of my rights and claims for damages I may have against sponsors, coordinating groups, and any individuals associated with the event, there representatives, successors and assigns for any and all injuries suffered by me in connection with said events. In filling out this form, I acknowledge that I am an amateur in such events. I also give my permission for the free use of my name and picture in any broadcast, telecast or print media account for this event. In filling out this form I acknowledge I have read and fully understand my own liability and do accept the restrictions.