We need your; Full Name including middle initial / Date of Birth / Drivers License Number and State issued
Full Name including middle initial / Date of Birth / Drivers License Number and State issued
Are there any medical conditions or allergies the race staff need to know about
Any random facts you want our Announcer to know?
PETERSON SFB AQUATIC CENTER ACCIDENT WAIVER AND RELEASE OF LIABILITY I acknowledge that this Aquatic Center (AC) activity is a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition environment, equipment, vehicular traffic, lack of hydration, and actions of other people; including but not limited to, participants, lifeguards, and instructors. I hereby assume all the risks of participating and/or volunteering in this event. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I am physically fit, have sufficiently trained for participation in the event, and have not been advised otherwise by a qualified medical person. I acknowledge that the activity organizers in which I may participate will use this Accident Waiver and Release of Liability (A WRL) form; and that it will govern my actions and responsibilities at said activities. In consideration of my application, and permitting me to participate in this event; I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release, and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter accrue to me or my traveling to and from this event; THE FOLLOWING ENTITIES OR PERSONS: AC, their manager, employees, volunteers, event volunteers; and (B) Indemnify and hold harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during this event. I understand that at this event or related activities, I may be photographed and/or videotaped. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, and organizers. This A WRL shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. Program Name and Date: Peterson SFB Triathlon