Event Registration Accident Waiver And Release Of Liability Name printable pdf download

Event Registration, Accident Waiver and Release of Liability, Name and Likeness

I certify that I am physically fit, have sufficiently trained and prepared for participation in this event and have not been advised

otherwise by a qualified medical person. I acknowledge that this athletic event is an extreme test of a person’s physical and

mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited

to, those caused by terrain, facilities, temperature, weather, condition of athletes, lack of hydration, equipment, vehicular

traffic, actions of other people including, but not limited to, participants, volunteers, spectators, journalist, event officials, event

monitors, and/or producers of the event. The risks are not only inherent to participants, but are also present for volunteers and

support staff. I hereby assume all of the risks of participating and/or volunteering in this event.

In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors,

administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all

liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter

accrue to me during or my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: Planet Ultra Inc.,

its directors, officers, employees, volunteers, representatives, owners, and agents, the event holders, event sponsors, event

directors, event volunteers, as well as any and all involved municipalities or other public entities and their respective agents

and employees; (B) Indemnify and Hold Harmless the entities and persons mentioned in this paragraph from any and all

liabilities or claims made by other individuals or entities as a result of any of my actions during this event.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness

during this event.

I have read, understand, and agree to abide by the rules of the event as published on the event website. I also understand that at

this event or related activities, I may be photographed. I agree to allow my name, photo, or likeness to be used for any

legitimate purpose by event holders, producers, sponsors, organizers and assigns.

I acknowledge that this Accident Waiver and Release of Liability (AWRL) form will be used by the event holders, sponsors,

and organizers, of the event(s) I may participate in and that it will govern my actions and responsibilities at said events. It is

further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assigns. This

AWRL shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I

certify that I have read this document and I understand its content.

Event____________________________________________________ Entry Fee __________________

Signature ____________________________________________________________________________

Name __________________________________________________ Date _______________________

Signature of parent or guardian if under 18 _________________________________________________

Address _______________________________________ Phone ________________________________

City ____________________________________________ State _____ Zip Code _________________

Age on 12/31 _____________

Circle: Male OR

Female

Email (mandatory) ____________________________________________________________________

Would you like to receive our “Plant Ultra News” email newsletter? Circle: Yes

Already Do!

Emergency Contact ____________________________________Phone __________________________

Event Registration Accident Waiver And Release Of Liability Name