Please review the following waiver and disclaimer. By clicking “I Accept” on the sign up form, you accept this waiver and disclaimer.

If you are under the age of 18, we need your name and the name of a parent/guardian.
Please include a Chaperone’s name as well if your parent/guardian will not be with you on Race Day.

 

Waiver and Release: I, by participating [allowing the above said minor to participate] in this event, do so at my own risk.
I assume all risk of injury, illness, damage or loss to me or my property [this minor or their property] that might result in, including without limitation, any loss or theft of personal property.


I consent to medical treatment for myself [above said minor] in the event of injury, accident and/or illness during the event.
I agree on behalf of myself [above said minor] and my personal representatives, heirs, executors, administrators, agents, and assigns, to release and discharge the organizers of this event, its principals, its officers and directors, its employees, all sponsors and their representatives and employees, the City of Elmira and its officers and employees from any and all claims or causes of action (known or unknown) arising out of their negligence.


I acknowledge that I have carefully read this ‘Waiver and Release’ and fully understand that it is a release of liability. By my electronic agreement, I am waiving any right that I may have to bring legal action to assert a claim against any and
all discharge the organizers of this event, its principals, its officers & directors, its employees, all sponsors and their representatives and employees, the City of Elmira and its officers and employees for their negligence.

I hereby grant full permission to any and all of the foregoing to use my [this minor’s] name and likeness in any broadcast, telecast, video, print or social media reporting or advertising of the event without compensation.

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Copyright 2019 Heathers' Home 5K.
All rights reserved.