Name of Run

 

9^TH TO 22^ND MARCH 2003

 

 

ACCIDENT WAIVER AND RELEASE OF LIABILITY / RELEASE OF NAME AND LIKENESS (AWRL)

 

NOTE:  ALL ………………………. ULTRA 2003 ENTRANTS, SUPPORT CREW MEMBERS, AND RACE OFFICIALS MUST AGREE TO THE TERMS IN THIS WAIVER AND TO THE GENERAL RULES SET OUT IN A SEPARATE DOCUMENT.  THIS WAIVER MUST BE SUBMITTED WITH THE ENTRY FORM.  CREWS MUST SIGN THE FORM AT THE PRE-RACE MEETING IF NOT BEFORE.

 

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, journalists, coaches, event officials, and event monitors, and /or producers of the event.  The risks are not only inherent to athletes, but are also present for volunteers and support staff.  I hereby assume all of the risks of participating and/or volunteering in this event.

 

I certify that I am physically fit, have sufficiently trained and prepared for participation in the event and have not been advised otherwise by a qualified medical person.

 

I acknowledge that this Accident Waiver and Release of Liability (AWRL) form will be used by the event holders, sponsors, and organizers, at any event in which I may participate and that it will govern my actions and responsibilities at said events.

 

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 the event or my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS:  ……………………………, volunteers, representatives, 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 or 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 understand that at this event or related activities, I may be photographed, filmed, and/or videotaped.  I agree to allow my name, photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers and assigns.

 

I have read, understand, and agree to abide by the General Rules of the event as set out in a separate document.  It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assigns.

 

All motorized vehicles used either for runner personal support or for officiating/staff/media purposes in the ………………… must be covered by at least the minimum legal requirements of property damage and personal injury liability automobile insurance for the state of ………., or for the state in which the vehicle is registered.

 

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

 

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

 

 

 

Signature________________________________________Date_____________

 

Please print your name______________________________________________

 

Crews: Name of Runner for whom you are crewing:_______________________

 

Address__________________________________________________________

 

City_______________________________State_____________Zip__________

 

Country____________________________

 

Emergency Contact Name:__________________________________________

 

Emergency Contact Phone Number:__________________________________