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WAIVER OF LIABILITY AND
ASSUMPTION OF RISK

&nbsp;
&nbsp; For
and in consideration of Merchant
Street Art Gallery of Artists with Autism Inc. its affiliates, members, allowing
me, the undersigned, to participate in the Merchant Street Art Gallery of Artists with Autism (MSAGAA) sanctioned event (Run for Autism) I am registering for herein (the
“Event”); I, for myself, and on behalf of my spouse,&nbsp; children,&nbsp;
guardians,&nbsp; heirs&nbsp; and&nbsp;
next&nbsp; of&nbsp; kin,&nbsp;
and&nbsp; any&nbsp; legal&nbsp;
and&nbsp; personal&nbsp; representatives, executors, administrators, successors and assigns, hereby agree to
and make the following contractual representations pursuant to this Waiver and
Release of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”).

&nbsp;

1. &nbsp;I hereby represent that (i) I am at least eighteen (18) years of age or older
(or that this document is also
agreed to by my
parent or legal guardian); and (ii) I am in good health and in proper physical condition to
participate in the Event. &nbsp;I agree that it is my sole responsibility to determine whether I
am sufficiently fit and healthy enough to participate in the Event, that I am responsible for my own safety and well-being at
all
times and under all circumstances while at the Event site.

&nbsp;

2. &nbsp;I understand and acknowledge that participation in races and walks is inherently dangerous and represents an extreme test of a person’s physical and mental limits. I understand and acknowledge the risks and dangers associated
with
&nbsp;participation &nbsp;in
&nbsp;the &nbsp;Event &nbsp;and
&nbsp;related
&nbsp;activities, &nbsp;including
&nbsp;without limitation, the potential for serious bodily injury, sickness,
permanent disability, paralysis and loss of&nbsp;
&nbsp;life;
loss of
or damage
to equipment/property;
exposure
to extreme conditions
and circumstances; contact with other participants, spectators, animals or other natural or manmade objects;
dangers arising from adverse weather conditions; imperfect course or track conditions; land, water and
surface
hazards;
&nbsp;equipment &nbsp;failure; &nbsp;inadequate &nbsp;safety measures; &nbsp;participants &nbsp;of &nbsp;varying &nbsp;skill &nbsp;levels; situations
&nbsp;beyond&nbsp;
the &nbsp;immediate &nbsp;control
&nbsp;of
&nbsp;the &nbsp;Event &nbsp;Organizers&nbsp; (as &nbsp;defined&nbsp; below);
&nbsp;and&nbsp; other
undefined, not readily foreseeable and presently unknown risks and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by my own actions or inactions, the actions or inactions of
others participating
in
the Event, or the negligent acts or omissions of the Released
Parties defined below, and I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or
expenses which
I incur as a result of my participation in
any Event.

&nbsp;

3. &nbsp;I agree to be familiar with and to abide by all the rules and regulations established for the Event, including &nbsp;but &nbsp;not
&nbsp;limited to
&nbsp;any
&nbsp;Competition &nbsp;Rules &nbsp;adopted &nbsp;by &nbsp;MSAGAA, &nbsp;any &nbsp;anti-doping
&nbsp;rules &nbsp;as
established by
the
appropriate entity, and any
safety regulations
established for
the
benefit of all
participants. I accept sole responsibility for my own conduct and actions while participating in the Event, and the condition
and adequacy of my equipment.

&nbsp;

4. &nbsp;I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold
Harmless MSAGAA, and, if applicable, the following parties: the event directors, organizers and
promoters, sponsors, advertisers, the
local organizing committee and the facility, venue and property owners or operators upon which the Event
takes place; law enforcement agencies and other public entities providing support for the Event; and each of their respective parent, subsidiary and affiliated companies, officers, directors, partners, shareholders,
members, agents, employees and volunteers (Individually
and Collectively, the “Released Parties” or
“Event Organizers”), with
respect to any
liability, claim(s), demand(s), cause(s) of action, damage(s), loss
or expense (including court costs and reasonable attorneys’ fees) of any kind
or nature (“Liability”) which may arise out of, result from, or relate in any way to my participation in the Event, including claims for
Liability caused in whole or in part by the negligent acts or omissions of the Released Parties. I further
agree that if, despite this Agreement, I,
or anyone on my behalf, makes a claim for Liability against any of the Released Parties, I
will indemnify, defend and hold harmless each of the Released Parties from any
such Liabilities which any may be incurred as the result of such
claim.

5.&nbsp; &nbsp;I hereby warrant that I
(or
my parent, natural guardian, or legal guardian, if I am under
the age of 18) am&nbsp;
of &nbsp;legal &nbsp;age
&nbsp;and
&nbsp;competent &nbsp;to
&nbsp;enter
&nbsp;into &nbsp;this
&nbsp;Agreement, &nbsp;that &nbsp;I&nbsp;
have &nbsp;read &nbsp;this
&nbsp;Agreement carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal rights by accepting it (including the rights of my spouse, children, guardians, heirs and next of kin, and
any legal and personal representatives, executors, administrators, successors and assigns), acknowledge that I have accepted this Agreement without any inducement, assurance or guarantee, and intend for my
acceptance to serve as confirmation
of my
complete
and unconditional
acceptance of the terms,
conditions&nbsp; &nbsp;and provisions
of this
Agreement.
This Agreement represents the complete understanding between
the parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this Agreement is held to be
unlawful, void, or for
any reason unenforceable, then that provision shall be deemed severable from this
Agreement and shall not affect the validity and enforceability of any remaining provisions.

&nbsp;

6. &nbsp;As a condition of my participation in the Event, I hereby grant MSAGAA,
a limited license to use my name, likeness, image, photograph, voice, video, athletic performance, biographical and
other
information (collectively,
"Likeness"), in
any media platform
or format
whatsoever, and to
distribute, broadcast and
exhibit these without charge,
restriction or liability, but only for the purposes of
advertising or promoting Event
or MSAGAA. The foregoing grant, however,
does
not constitute consent for MSAGAA or any third party
to use my Likeness in an
endorsement of any
product or
service without my specific written consent.

&nbsp;

7. &nbsp;I certify that the birth date and age information provided in my member profile and confirmed at the beginning of the entry process is true and accurate.

&nbsp;

8.&nbsp;&nbsp; &nbsp;If &nbsp;the
&nbsp;participant &nbsp;is
&nbsp;under
&nbsp;the &nbsp;age
&nbsp;of
&nbsp;18,
&nbsp;the &nbsp;parent,
&nbsp;natural
&nbsp;guardian,
&nbsp;or
&nbsp;legal
&nbsp;guardian &nbsp;(the

“Guardian”) hereby agrees to
release and
discharge MSAGAA as follows:

a. The Guardian
acknowledges and understands that the Event is inherently dangerous and
represents an extreme test of a person’s physical and mental limits.
Further, the Guardian acknowledges and understands the Risks, as defined above.

b.&nbsp; &nbsp;The Guardian acknowledges the rights waived by both the Guardian and the participant by accepting this Agreement.

c.&nbsp;&nbsp; The Guardian acknowledges that the Guardian will indemnify the Released Parties from any
and all Liability
which may
arise out of, result from, or relate in any way
to
the participant’s participation in the Event, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released
Parties.

Parent/Guardian Initials

Initial to verify you agree to the above waiver.

Name

Relationship

Family Friend

Phone

Contact cannot be an event participant.

Donation

$1 $2 $5 $10 $20 $50

$100 $250 $500 No Thanks Other Donation Amount

Merchant Street Art Gallery of Artists with Autism
Learn more about us and our mission at http://www.merchantstreetartgallery.org/

Art gallery showing and selling the art of artists with autism while helping the artists gain the skills to support themselves with their art.

For more about the event go to www.runforautism.com

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Have a great race!

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