Path to Opioid Prevention 5K and Half Marathon PARTICIPANT WAIVER, RELEASE OF LIABILITY COVENANT NOT TO SUE & IMAGE RELEASE In consideration of being allowed to participate in the above referenced Path to Opioid Prevention 5K and Half Marathon competition and related events (the “Event”) I, the undersigned, acknowledge, covenant and agree that: 1.It is my desire to participate as in the event listed above (the "Event"). Prior to my participation in the Event, I acknowledge that certain risks are associated with my participation, including physical injury due to event-related accidents; physical injury due to transportation-related accidents; and illness, or even death. I acknowledge that there may be other risks inherent in my participation in the Event of which I may not be aware. While particular rules, equipment, and personal discipline may reduce these risks, the risk of death or serious injury exists. I will not enter and/or participate in the Event unless I am medically able and properly trained. By my signature, I certify that I can medically perform this event, and am in good health, and I am properly trained. I agree to abide by any decision of a race official relative to any aspect of my participation in this event, including the right of any official to deny or suspend my participation for any reason whatsoever. 2. AFTER HAVING HAD OPPORTUNITY TO FULLY INFORM MYSELF, WHICH INFORMATION I ACKNOWLEDGE, ABOUT THE EVENT, I KNOWINGLY AND FREELY ASSUME AND ACCEPT ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN, and assume full responsibility and all risks for my participation in the Event; 3. I voluntarily agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual and/or significant hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the nearest official; 4. I, for myself and on behalf of my heirs, assigns, personal representatives and/or next of kin, forever WAIVE, RELEASE, DISCHARGE and COVENANT NOT TO HOLD Bonneville Communities That Care, Riverdale City, South Ogden City, Uintah City, Weber Human Services, and their affiliates/Key Leaders, directors, representatives, officials, principals, agents and/or employees, subsidiaries, and/or assigns, and their independent contractors, sponsoring agencies, sponsors, advertisers, volunteers, and if applicable, owners and lessors of the premises used to conduct the Event (collectively, "BCTC & Affiliates"), ACCOUNTABLE WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, and/or loss or damage to person or property, incurred by me in connection with my participation in the Event. I further agree to indemnify, defend and hold harmless BCTC & Affiliates from any loss, liability, cost, claim or damages arising from my participation in or association with activities and events organized connected with the Event. 5. I attest and verify that, unless otherwise stated below, I am over 18 years of age, am free from all illnesses, injuries and defects that could interfere with my safe participation in the Event and that I am physically fit and sufficiently trained to participate in all activities associated with the Event. My participation in activities and the Event, is entirely voluntary. I further certify and represent that on the date of the Event I will possess and be covered by medical/health insurance, individually or as part of an organization. 6. I consent to administration of first aid and other medical treatment if injury or illness occurs and release and agree to indemnify BCTC & Affiliates from and against any and all liability or claim arising out of such treatment. 7. BCTC & Affiliates reserve the right, in their sole and absolute discretion, to postpone, cancel, or modify any event due to weather conditions, Acts of God or other factors beyond the control of BCTC & Affiliates that might affect the health and/or safety of the participants. In the event of such postponement, cancellation, or modification, no refunds will be paid. 8. PUBLICITY: I irrevocably and absolutely grant permission to BCTC & Affiliates to film, videotape, record, photograph or create any other depiction of any kind, of me or my participation or performance or of the named participant (referred to herein as “I”, “me”, “my”) in the Event and subsequently to telecast, sell, distribute and otherwise utilize the same in whatever manner BCTC & Affiliates shall deem appropriate. Such permission shall include granting the unlimited and irrevocable right to BCTC & Affiliates, without compensation of any kind to me, to use, reproduce or broadcast, my name, image, likeness, voice, photograph, signature facsimile, and biographical information in connection with the Event without compensation of any kind to me. I acknowledge that BCTC & Affiliates and their representatives shall have the unlimited right throughout the world to copyright, use, reuse, publish, republish, broadcast and otherwise distribute depictions of or information about me and all or any portion of the Event in which I may appear on any radio, network, cable and local television programs and in any print materials and in any other format or media (including electronic media) now known or hereinafter devised or created, in perpetuity and without compensation to me. In consideration of, and in return for, being allowed to participate in the Event, I release and agree not to sue BCTC & Affiliates from all present and future claims regarding my participation in the Event that may be made by me, my family, estate heirs, or assigns. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. Signature _______________________________________ Date ____________________ Participant Name (PRINT): __________________________________________________ Phone:_________________________Email:__________________________________________ Date of Birth:______________________________________
EMERGENCY CONTACT (required) Name ___________________________________________ Phone __________________
MINORS: IF UNDER 18 – SIGNATURE OF PARENT OR GUARDIAN (required) The undersigned, _______________________________________, certifies, warrants and represents that I am the legal parent or guardian of _________________________, the signer of the above Release (the “Participant”), and that after fully informing myself of the nature and risks of the Event, I give my permission for Participant to participate in the Event and by my signature below I ratify, accept and agree to the terms of this Release both for myself individually and as legal parent, representative or guardian of the Participant. Signature _______________________________________ Relationship to minor: _____________________