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Warrenville Park District Firecracker 5K - 2022

Warrenville Park District Waiver and Release of all Claims & Emergency Treatment Permission
Please read this form carefully and be aware in signing this form and participating in the programs listed above that you will be waiving and releasing all claims for injuries you or your children might sustain arising out of these programs As a participant in these Warrenville Park District programs, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages or loss which I may sustain as a result of participating in any and all activities connected with or associated with such programs. I agree to waive and relinquish all claims I may have as a result of participating in the programs against the Warrenville Park District and its officers, agents, servants and employees. I do hereby fully release and discharge the Warrenville Park District and its officers, agents, servants and employees from any and all claims from injuries, including death, damages and losses which I may have or which may occur to me on account of participation in these programs. I further agree to indemnify and hold harmless and defend the Warrenville Park District and its officers, agent’s servants and employees from any and all claims resulting from injuries, including death, damages and losses sustained by me or arising out of, connected with, or in any way associated with the activities of these programs. In the event of any emergency, I authorize the Warrenville Park District officials to secure from any licensed hospitals, physician, and/or medical personnel, any treatment deemed necessary for my immediate care and agree that I will be responsible for payment of any and all medical services rendered. I have fully read and fully understand the Registration Policies. Waiver and Release of all Claims and Permission to secure treatment. The Warrenville Park District does not carry medical or accident insurance for program participants. Please review your own health insurance to be certain that you and your family have adequate coverage.

Please read this form carefully and be aware that in   signing up for and participating in programs/ activities, you will be expressly assuming the risk waiving and   releasing all claims from injuries you or your children might sustain arising out of these programs. As a            participant in Warrenville Park District programs, I      recognize and acknowledge that there are certain risks of physical injury and I agree to assume full risk of any   injuries, including death, damages, or loss which I  may sustain as a result of participating in any and all activities connected with or associated with such programs. I agree to waive and relinquish all claims that I may have as a result of participating in the programs against Warrenville Park District, City of Warrenville, DuPage Forest        Preserve and DuPage County and their officers, agents, servants and employees. I do hereby fully release and discharge the Warrenville Park District, City of           Warrenville, DuPage Forest Preserve and DuPage

County and their officers, agents, servants and

employees from any and all claims from injuries,

including death, damages, and losses which I may have or which may occur to me on account of participation in these programs. I authorize the Warrenville Park District, City of Warrenville, DuPage Forest Preserve and DuPage County officials to secure from any licensed hospital, physician, and/or medical personnel, any treatment deemed necessary for any immediate care and agree that I will be responsible for payment of any and all    medical services rendered. The Warrenville Park District, City of Warrenville, DuPage Forest Preserve and DuPage County does not carry medical or accident insurance for program participants.

 

I understand that my child/ward or I may be photographed or videotaped while participating in a Warrenville Park District program or special event. I give my permission for photos and videotapes of my child/ward or myself to be used to promote the Warrenville Park District through brochures, flyers and social media. Such photos and videotapes will remain the property of the Warrenville Park District.

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, Warrenville Park District Firecracker 5K, and individual Warrenville Park District Firecracker 5K 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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