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I am an adult and/or guardian, and have decided to participate and/or allow a minor under the age of 18 to participate in this event hosted by a federally funded grant project, Behavioral health Workforce Education for Longitudinal Learning (BWELL) grant project and Washburn University as part of Run for Your Life 5K and associated activities. My participation is wholly voluntary. In consideration of BWELL/Washburn University’s agreement to permit me to participate, I agree as follows:

1. I recognize and acknowledge that BWELL/Washburn University/Shawnee County does not carry health or hospital insurance that would provide insurance coverage for me in the event I should sustain an injury while participating in events hosted by BWELL and Washburn University as part of Run for Your Life 5K and associated activities.

2. With the full knowledge that participation in events hosted by BWELL, Washburn University, and Shawnee County as part of Run for Your Life 5K and associated activities involves the risk of injuries, including but not limited to sprains, scrapes, lacerations, fractures, concussion and death, I freely and voluntarily accept and assume any and all such risks. 

3. I, individually, and on behalf of my heirs, successors, assigns and personal representatives, hereby release, forever discharge and agree to defend, indemnify and hold harmless BWELL, Washburn University, and Shawnee County Parks and Rec, and its employees, agents, officers, trustees and representatives from and against any and all liability whatsoever for any and all damages, losses or injuries (including death) I sustain to my person or property or both, including but not limited to any claims, demands, actions, causes of action, judgments, damages, expenses, costs, and attorneys fees, which arise out of, result from, occur during or are in any way connected, directly or indirectly, to my participation in events hosted by Washburn University as part of Run for Your Life 5K and associated activities and any travel incident thereto.

4. I hereby freely and willingly give BWELL, Washburn University and its authorized agents and employees the absolute right and unrestricted permission to copyright, use and/or publish my photographic likeness in any form for the purpose of advertising, for endorsing or promoting such University in any print or electronic media.

5. I waive any right that I may have to inspect and approve the finished product or the copy that may be used in connection with the likeness or the use to which it may be applied. It is understood that my name may or may not be used in conjunction with the photographic/videography likeness. It is understood that no compensation has been paid and that no fee shall be due from me, and/or no compensation shall be due to me for giving permission to such BWELL and Washburn University for the use of my photographic/videography likeness for the purpose stated above.

6. I hereby acknowledge that I have read this entire document, that I understand its terms, that by signing it I am giving up substantial legal rights I might otherwise have, and that I have signed it knowingly and voluntarily.