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Carroll Anthony Briggs Walk-A-Thon Waiver & Release Form

EVENT DISCLAIMER

Please review the following waiver and disclaimer. By adding your signature, you accept this waiver and disclaimer. Wavier and Release:


By participating in the Carroll Anthony Briggs Walk-A-Thon, I acknowledge, appreciate, and agree that:


* The risk of injury from the activities involved in the walkathon, including the potential for permanent paralysis and death.


* I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others and assume full responsibility for my participation.


* I willingly agree to comply with terms and conditions for participation. If I observe any unusual significant hazard or medical issue during my presence and/or participation, I will remove myself from participation and bring such to the attention of event organizer, nearest official, or medical team immediately.


* I, for myself and on behalf of my heirs, assigns, personal representative and next of kin, HEREBY RELEASE, IDENTIFY, AND HOLD HARMLESS THE BETHESDA BAPTIST CHURCH, its officers, officials, members, and other participants, from any and all claims, demands, losses, and liability airing out of or related to any INJURY, DISABILITY OR DEATH I may suffer, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law.


I HAVE READ THIS RELEASE AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Full Name of Person Walking*

Email Address of Person Walking*

Mailing Address, to include City, State and Zip Code*

10 Digit Phone #*

Emergency Contact (Name & Telephone Number):*

Name of Adult who will be walking.

Signature*

Please list the name of all children for whom you are the parent or guardian.

Guardians' Signature

Guardian's Email Address

Participant/Guardian Signage Date:*

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