By indicating your acceptance, you understand, agree, warrant and covenant as follows:
In consideration of the foregoing, I, for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages I have against the 2017 Fund Drive for Navy-Marine Corps Relief Society 5K Mud Run Challenge at Naval Support Activity Mid-South principals, Navy-Marine Corps Relief Society, United States Navy, all sponsors and their representatives and any all claims against damages, demands, actions, whatsoever in any manner as a result of my participation in 2017 Fund Drive for Navy-Marine Corps Relief Society 5K Mud Run Challenge at Naval Support Activity Mid-South including but not limited to any injuries I might suffer or damages to clothing or personal items.
I acknowledge that I am aware of the inherent risks in participating in an athletic event of this type. I attest and verify that I am physically fit and have trained sufficiently for the competition of this event and my physical condition has been verified by a licensed medical doctor. Further, I hereby grant full permission to any and all of the foregoing to use my name, my voice, and or my picture in any broadcast, telecast, advertising, promotion or other account of this event for any purpose whatsoever.
I understand that the entry fee is non-refundable and individual numbers are nontransferable. If you are under a physician’s care for any chronic condition you should check with your physician before you begin training for the 2017 Fund Drive for Navy-Marine Corps Relief Society 5K Mud Run Challenge at Naval Support Activity Mid-South and again before participating in the 2017 Fund Drive for Navy-Marine Corps Relief Society 5K Mud Run Challenge at Naval Support Activity Mid-South.
2. Waiver. YOU UNDERSTAND THAT PARTICIPATION IN THE EVENT IS POTENTIALLY HAZARDOUS, AND THAT A REGISTERED PARTY SHOULD NOT PARTICIPATE UNLESS THEY ARE MEDICALLY ABLE AND PROPERLY TRAINED. YOU UNDERSTAND THAT EVENTS MAY BE HELD OVER PUBLIC ROADS AND FACILITES OPEN TO THE PUBLIC DURING THE EVENT AND UPON WHICH HAZARDS ARE TO BE EXPECTED. PARTICIPATION CARRIES WITH IT CERTAIN INHERENT RISKS THAT CANNOT BE ELIMINATED COMPLETELY RANGING FROM MINOR INJURIES TO CATASTROPHIC INJURIES INCLUDING DEATH. YOU UNDERSTAND AND AGREE THAT IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE EVENT, YOU AND ANY REGISTERED PARTY, THE HEIRS, PERSONAL REPRESENTATIVES OR ASSIGNS OF YOU OR THE REGISTERED PARTY DO HEREBY RELEASE, WAIVE, DISCHARGE AND CONVENANT NOT TO SUE ACTIVE FOR ANY AND ALL LIABILITY FROM ANY AND ALL CLAIMS ARISING FROM PARTICIPATION IN THE EVENT BY YOU OR ANY REGISTERED PARTY.
3. Severability. You further expressly agree that this Agreement and Waiver is intended to be as broad and inclusive as is permitted by the law of the State of Tennessee and that if any provision of this Agreement and Waiver shall be found to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and Waiver and shall not affect the validity and enforceability of any remaining provisions.
4. BY INDICATING YOUR ACCEPTANCE OF THIS AGREEEMENT AND WAIVER, YOU ARE AFFIRMING THAT YOU HAVE READ AND UNDERSTAND THIS AGREEMENT AND WAIVER AND FULLY UNDERSTAND ITS TERMS. YOU UNDERSTAND THAT YOU ARE GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. YOU ACKNOWLEDGE THAT YOU ARE SIGNING THE AGREEMENT AND WAIVER FREELY AND VOLUNTARILY, AND INTEND BY YOUR ACCEPTANCE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
[ ] Initials of participant over 18 years of age or parent/legal guardian of minor under 18 years of age or legal guardian of incapacitated and/or mentally challenged person.
RACE CATEGORY: (circle one)
TEAM OPEN / TEAM B&U / COMMAND TEAM CHALLENGE
FIRST NAME: ______________________________________________________
LAST NAME: _______________________________________________________
GENDER: M / F BIRTH DATE: ___________________________
AGE ON RACE DAY: ______________________________________
T-SHIRT SIZE: XS / S/ M / L/XL /XXL
TEAM NAME: ___________________________________________
ARE YOU: MILITARY / DOD CIVILIAN / CIVILIAN
IF MILITARY, WHAT BRANCH: ________________
PARTICIPANT SIGNATURE: ______________________ DATE: ______________