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Print out and bring the signed waiver to pre-registration or to the race. You must have the form completed and turned in prior to event start. |
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Thank you for registering for the 2009 Community Care Fitness Run. Family Captains, please printout the following Release Form and have each of your family members sign their agreement to the following. (Parent must sign if runner is under 18 years old) |
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FAMILY RELEASE FORM |
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*EACH participant must provide a signature to certify the following statement (Parent must sign if runner is under 18 years old): I know that running a race is a potentially hazardous activity and that I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants and wildlife, the effects of the weather, including cold and/or rain or snow, traffic and the conditions of the road and path, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the organizers of the Community Care Fitness Run, City of Idaho Falls, Idaho, PERSONAL BEST Performance, and all other sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event or carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purposes. |
| Team Name: _____________________________________________________ |
| Address: _______________________________________________________________ |
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City: ____________________________
State: ____________ Zip:
______________
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| Team Captain Phone:___________________ Team Captain Email: ___________________ |
| Team Member #1: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
| Team Member #2: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
| Team Member #3: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
| Team Member #4: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
| Team Member #5: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
| Team Member #6: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
| Team Member #7: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
| Team Member #8: | _________________________ PRINT NAME |
_________________________ RELEASE SIGNATURE |
Print out and bring the signed waiver to pre-registration or to the race. You must have the form completed and turned in prior to event start.