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HARTZ PT Fall Blast - 2022


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Mandatory Release Form: I know that running and road racing are potentially hazardous activities. I will not participate in this event unless I am medically able and properly trained. I agree to abide by any decision of a race official related to my ability to safely complete the course. I assume all risk(s) associated with running including but not limited to; falls, contact with other participants, the effect of the weather (including high heat and humidity) and conditions of the road, including traffic. All such risks are being known and assumed by me. Having read this waiver and knowing these facts, and in accordance of you accepting my application, I for myself and anyone entitled to act on my behalf, waive and release Hartz Physical Therapy, Bench Mark Program, the town of Lititz, Lititz police department, Warwick and Penn Townships, Warwick School District, and any other and all other clubs or organizations assisting at the event on race day, as well as all sponsors, their representatives and successors, from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons or entities named in the waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose, including but not limited to, future event promotions and advertisements.

Signature*_______________________________________________
(*If under 18, signature of parent or guardian is required)

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, HARTZ PT Fall Blast, and individual HARTZ PT Fall Blast 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 .


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