{{::eventInfo.eventName}}

RELEASE OF LIABILITY WAIVER (Adult) In consideration of the acceptance of this entry I waive all claims for myself and my heirs against the sponsors, cooperating and coordinating groups and any individuals associated with this event and will hold them harmless for any and all injuries which may result from my participation. I hereby give my permission to the media to use my name and photograph in the newspaper, broadcast, telecast of this event without limitation or obligation. I certify that I am physically fit for this event and understand the risks involved by participating in this event. Signature __________________________________ Date______________________________________       - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -     PARENT / GUARDIAN CONSENT FORM AND LIABILITY WAIVER Participant name _________________________________           Birth Date_____________________ Sex _______________   Parent/Guardian Name___________________________________________ Home Phone_____________________________________   I, ___________________________, grant permission for my child, ____________________________, to participate in the 5K Unity Walk/Run. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (“participant”). I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend the 5K Unity Walk/Run, its officers, directors and agents, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the 5K Unity Walk/Run, its officers, directors and agents, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith. Medical Matters: I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child.     Signature_____________________________________ Date______________________________