Participant  Waiver

MILES FOR MATT HERSHEY 5K WALK

PARTICIPANT WAIVER

NAME:

DATE OF BIRTH:

I understand and agree that my participation in MILES FOR MATT HERSHEY

5K WALK is conditional upon my execution of this document. I am aware

that walking involves the possibility of injury. I accept this risk, and all

others arising from this event, even if arising from the negligence, gross

negligence or negligent rescue by those associated in any way with

MILES FOR MATT HERSHEY, including it's officers and volunteers. I

understand that all applicable rules for participation must be followed and

that SOLE RESPONSIBILITY FOR MY PERSONAL SAFETY REMAINS WITH ME,

including my preparation and fitness to participate in this event. I

undertake and agree to remove myself from participation if I sense or

observe any unusual hazard or unsafe condition, or if, at any time, at the

event, I feel unable or unfit to safely continue for any reason. I give a

FULL RELEASE AND WAIVER OF LIABILITY AND ALL CLAIMS that I have,

or may have in the future against MILES FOR MATT HERSHEY from all

liability for any loss damage, injury or expense that I may suffer as a result

of my participation in any part or parts of the event. I AGREE NOT TO SUE

and I further agree TO INDEMNIFY AND SAVE HARMLESS the Releases

from all expenses, fees, liability or damage award or cost of any type

whatsoever arising from my participation inn this event.

I HAVE READ AND UNDERSTOOD THIS WAIVER, RELEASE AND INDEMNITY.

I am aware that by signing this agreement I am waiving substantial legal

rights (on my behalf and on behalf of my or the child/ward's heirs,

executors, administrators and next of kin), including the giving up of my

right to sue.

　

SIGNATURE ____________________________ DATE __________________

 

WAIVER OF LIABILITY RELATING TO CORONAVIRUS/COVID-19: Miles for Matt Hershey will follow the CDC recommended guidelines in order to protect you, the public, our walkers, and volunteers. We will monitor incoming COVID-19 updates and amend and adjust these guidelines as the situation develops. All individuals are required to wear masks to reduce the risk of exposure. By signing below you agree to comply with the required safety measures and understand that Miles For Matt is not responsible and cannot be held liable for any potential exposure to Novel Coronavirus or Covid-19.

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SIGNATURE OF PARTICIPANT ____________________________ DATE __________

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SIGNATURE OF PARENT/GUARDIAN_______________________ DATE ________

　

RESPONSIBLE ADULT CONSENT FOR MINOR PARTICIPANT and

INDEMNITY AGREEMENT

I have read and understood the above waiver, release and indemnity.

In consideration of the participation of my minor child/ward I agree to

waive, release and indemnify the Releases in the terms set out above.

I am aware that by signing this agreement I am waiving substantial legal

rights, which the minor child/ward and I, our respective heirs, executors,

administrators and next of kin may have against the Releases.

　

SIGNATURE ____________________________ DATE _________________

Privacy Notice: Information collected in this waiver will not be shared with third parties

not involved with this event.