Print out and bring the signed waiver to
pre-registration or to the race. You must have
the form completed and turned in prior to event start.
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Thank you for registering for the Summit Orthopaedics
18th Annual To Bone & Back.
Team Captains, please printout the following Release Form and
have each of your participating team members sign their
agreement to the following. (Parent must sign if
runner is under 18 years old) |
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FAMILY
AND TEAM RELEASE FORM
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*EACH participant must provide a signature to certify the following
statement (Parent must sign if runner is under 18 years old):
I know that participating in a running
event is a potentially hazardous activity and that I should not enter
and complete unless I am medically able and properly trained. I agree to
abide by any decision of a race official relative to my ability to
safely complete the event. I assume all risks associated with running in
this event including, but not limited to: falls, contact with other
participants and wildlife, the effects of the weather, including cold
and/or rain or snow, traffic and the conditions of the road and path,
all such risks being known and appreciated by me. Having read this
waiver and knowing these facts and in consideration of your accepting my
entry, I, for myself and anyone entitled to act on my behalf, waive and
release the organizers of the Bone and Back event, City of Idaho Falls
County of Bonneville, State of Idaho, Summit Orthopeadics, PERSONAL BEST
Performance, and all other sponsors, their representatives and
successors from all claims or liabilities of any kind arising out of my
participation in this event or carelessness on the part of the persons
named in this waiver. Further, I grant permission to all of the
foregoing to use any photographs, motion pictures, recordings, or any
other record of this event for legitimate purposes. |
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| Team Name:
_____________________________________________________ |
| Address:
_______________________________________________________________ |
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City: ____________________________
State: ____________ Zip:
______________
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| Team Captain
Phone:___________________ Team Captain Email: ___________________ |
| Team
Member #1: |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
| Team Member #2: |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
| Team
Member #3: |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
| Team Member #4: |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
| Team
Member #5: |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
| Team Member #6: |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
| Team
Member #7: |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
| Team Member #8 |
_________________________
PRINT NAME
|
_________________________
RELEASE SIGNATURE |
Print out and bring the signed waiver to pre-registration or to the
event. You must have the form completed and turned in prior to
event start.
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