PARTICIPATION WAIVER AND RELEASE OF LIABILITY
City: ___________________________________________________________ State: ________ Zipcode: ____________________
Email Address: ______________________________________________________ Phone Number: ______________________________
Emergency Contact: ________________________________________________ Phone Number: ______________________________
By signing, you agree to the following:
EVENT WAIVER AND RELEASE OF LIABILITY
I (we), including any family member, and/or minor children accompanying me, am about to voluntarily participate in “The Miracle Miles” event, a series of running and exercise activities organized, operated, funded, and/or supplied by the Dick Pond Racing Team, The Batting for a Cure Foundation, Benet Academy, and their sponsors, respective leaders, organizers, officers, directors, employees, agents, attorneys, and other representatives, including without limitation, Dick Pond Athletics, Inc., and any and all of Dick Pond Athletics, Inc.'s parent entities, subsidiaries, affiliated entities, shareholders, directors, officers, employees, agents, and other representatives (collectively referred to as the Released Parties).
I (we) understand that The Miracle Miles will involve rigorous running and related physical exercise and activities, and notwithstanding any other provision in this Waiver and Release, I (we) understand that my participation in the Miracle Miles activities is purely and completely voluntary, and that at no time will I (we) be required to act, or refrain from acting, by Dick Pond Racing or by any of its organizers or representatives.
By accepting this Waiver and Release, I (we) acknowledge that the Released Parties shall not be, and shall never be, legally responsible for my personal health, or any pain, discomfort, or injury of any kind, including without limitation any disability or death, that I(we) may suffer which arise from or relate to my (our) participation in The Miracle Miles Activities, or any damage or loss to any of my property. I (we) hereby release, hold harmless, and forever discharge the Released Parties from any and all liability or damages to me (us), any member of my family, my heirs or assigns, or my property arising from or related to the Miracle Miles activities described herein.
I (we) understand that at various events, I (we) may be photographed. I (we) agree to allow my photo, video, or film likeness to be used for The Miracle Miles social media and marketing purposes.
Participant Signature: ________________________________________________________ Date: _____________________________
Parent (Guardian) Signature: __________________________________________________ Date: _____________________________
(required if participant is under the age of 18)