Waiver and Release of Liability
In consideration of the risk of injury while participating in the Southern Iowa Mental Health Centerâ€™s Outrun the Stigma 5k (THE â€œActivityâ€), and as consideration for the right to participate in Southern Iowa Mental Health Centerâ€™s Outrun the Stigma 5k, I hereby, for myself, my heirs, executors, administrators, assigns or personal representatives, knowingly and voluntarily enter into this waiver and release of liability, and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation of the Southern Iowa Mental Health Centerâ€™s Outrun the Stigma 5k, and do hereby release and forever discharge Southern Iowa Mental Health Center, located at 1527 Albia Rd. Ottumwa, IA 52501, their affiliates, managers, members, agents, attorneyâ€™s, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in Southern Iowa Mental Health Centerâ€™s Outrun the Stigma 5k, including traveling to and from an event related to this activity.
I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND AM PARTICPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH TRAVELING TO AND FROM AS WELL AS PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISBAILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOITONAL LOSS AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS NEGLIGENCE, CONDITIONS RELATED TO TRAVEL OR THE CONDITION OF THE ACTIVITY LOCATION(S). NONETHELESS I ASSUME ALL RISKS, BOTH KNOWN OR UNKNOWN TO ME OF MY PARTICIPATION IN THIS ACTIVITY, INCLUDING TRAVEL TO, FROM AND DURING THE ACTIVITY.
I agree to indemnify and hold harmless Southern Iowa Mental Health Center against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorneyâ€™s fees and any related costs if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Southern Iowa Mental Health Center incurs any of these types of expenses, I agree to reimburse Southern Iowa Mental Health Center.
I acknowledge that Southern Iowa Mental Health Center and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Southern Iowa Mental Health Center.
I ACKNOWLEDGE THAT THIS ACTIVITY MAY INVOLVE A TEST OF A PERSONâ€™S MENTAL AND PHYSICAL LIMITS AND MAY CARRY WITH IT THE POTENTIAL FOR DEATH, SERIOUS INJURY, AND PROPERTY LOSS. The risk may include but are not limited to those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of others including but not limited to, participants, volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event.
I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS â€œWAIVER AND RELEASEâ€ AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Southern Iowa Mental Health Center AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDESCESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Southern Iowa Mental Health Center FOR PERSONAL INJURY OR PROPERTY DAMAGE.
To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of Southern Iowa Mental Health Center, its agents, and employees.
In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.
In the event that any damage to equipment or facilities occurs as a result of my or my familyâ€™s willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.
This Agreement was entered into at armâ€™s-length, without duress or coercion, and is interpreted to be as an agreement between two parties of equal bargaining strength. Both the Participant, _________________________, and Southern Iowa Mental Health Center agree that this agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purposes for which is it entered into.
In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If the court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become invalid and unenforceable, then said provision shall be deemed to be written, construed and enforced as so limited.
In an event of an emergency, please contact the person(s) in the order presented:
Emergency Contact Contact Relationship Contact Telephone
I, the undersigned participant, affirm that I am of the age of 18 years or older, and that I am freely signing this agreement. I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a release of liability and that I am signing it of my own free will.
Parent/Guardian Waiver For Minors
In the event that the participant is under the age of consent (18 years of age), then this release must be signed by a parent or guardian as follows:
I hereby certify that I am the parent or guardian of _________________________, named above, and do hereby give my consent without reservation to the foregoing on behalf of this individual.
Relationship to Minor:
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, Out Run the Stigma, and individual Out Run the Stigma 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 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 .