RELEASE AND WAIVER FORM
IN CONSIDERATION of accepting the opportunity to voluntarily participate in Be the Light Walk, ("Walk"), for myself, my personal representatives, assigns, heirs, and next of kin:
1. ACKNOWLEDGE, agree, and represent that I knowingly accept all risks associated with this Walk, including but not limited to: falls; contact with other Walk participants; weather conditions, including possible high heat and humidity; path conditions; traffic; acts of God and forces of nature; and other such risks being known to me.
2. FULLY UNDERSTAND that:
(a) I am solely responsible for my own health and safety, and that the course which Walk participants will be walking will largely be unsupervised.
(b) I will wear properly fitted footwear and suitable bodily clothing enabling me to safely participate in this event and to walk on all surfaces and under the forecasted weather conditions of the day.
(c) Bicycles, inline skates, "wheelie" footwear, skateboards and scooters are not permitted.
(d) I consent to receive medical treatment which may be deemed advisable in the event of injury or illness during the Walk.
3. CODE OF CONDUCT: I agree that while onsite at the Be the Light Walk and related event(s) I will not engage in any behavior that is illegal or obscene. I will not harass or mistreat other runners/walkers, participants, or sponsors. I understand that members of the Be the Light Walk staff have the right to refuse my participation and limit the future participation of me personally or my company/team if I am deemed to be violating these terms.
4. HEREBY RELEASE, discharge, and covenant not to sue the Bellin Foundation, Brown County Coalition for Suicide Prevention, Family Services of Northeast Wisconsin, their administrators, directors, agents, officers, volunteers and employees, and other participants, sponsors, advertisers and, if applicable, owners and lessors of premises on which the Walk takes place (each considered one of the releasees herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the releasees or otherwise, and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my behalf, makes a claim against any of the releasees, I will indemnify and save, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss liability, damage, or cost which may incur as the result of such a claim. I further agree that if legal action is brought against any of the releasees contemplated in this paragraph, it must be brought in the State of Wisconsin.
I have read this agreement, fully understand its terms, and understand that I have given up substantial rights by signing it and have signed it freely and without any inducement, duress, or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by Wisconsin state law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force. If I am under 18 years of age at the time of registration, my parent or legal guardian has completely reviewed this Waiver and Release, understands and consents to its terms, and authorizes my participation by his/her signature below. Walk participants irrevocably grant, at no cost, Bellin Foundation and members of the Brown County Coalition for Suicide Prevention the absolute right and permission to use their name, voice, image, likeness, biographical materials world-wide, in perpetuity, in all forms of media now and forever known, including video footage, for the sole purposes of advertising, promoting, reporting and disseminating information regarding the Walk and Walk participants.
In signing this waiver, I acknowledge and represent that I have read and understand this release and agree to it voluntarily.
WAIVER: I, the undersigned participant (and my parent or guardian if I am younger than 18 years of age), intending to be legally bound, do hereby forever release and waive any and all rights, claims, and actions for damages that we, our heirs, executors, administrators, and assigns may have, or that may hereafter accrue against any and all persons, organizations, and other entities associated with the event, including, but not limited to Race Entry, sponsors, affiliates, volunteers, BE THE LIGHT WALK, and individual BE THE LIGHT WALK organizers, arising out of or in connection with my involvement before, during, or after the event.
I verify that I am physically fit and sufficiently trained to participate in this event and I assume the risks involved in this activity. I further attest that I will be mindful of traffic along the race course, and hold said sponsors and organizers blameless in any harm that may happen.
I consent to the collection and use of my Personal Information as contained in the Privacy Policy. I also give my permission for the free use of my name and/or pictures in telecasts, broadcasts, newspapers, posters, advertising, etc.
I also acknowledge understanding that the charge to my card will show up as Race Entry. I acknowledge that the online processing fees and charitable donations are non-refundable. I also acknowledge that any charitable donations will have 4.97% withheld from the donation to pay credit card and administrative costs.
Race Entry shall not be liable to you for any direct, indirect, special, incidental, consequential or exemplary damages including, but not limited to, loss of profits, goodwill, use, data or other intangible loses. Race Entry does not guarantee the completeness or accuracy of any information contained in, or provided in conjunction with the http://www.raceentry.com website. Race Entry is not responsible for any omissions or inaccuracies, or for the results obtained from this information.
Race Entry facilitates registration for various events, some of which allow participants under the age of thirteen (13). We require a submission of birth date for all registration entries. For children under the age of thirteen (13), parental or guardian consent is required.
You agree that the statutes and laws of the State of Utah, USA, will apply to all matters relating to this Agreement and Waiver. You irrevocably consent that exclusive jurisdiction for any dispute with Race Entry relating to this Agreement and Waiver resides in the courts of Utah, and you further agree and expressly consent to the exercise of personal jurisdiction in the courts of Utah in conjunction with any such dispute including any claim involving Race Entry .
