This is to certify that the undersigned is aware that any form of sports like the CORDILLERA MOUNTAIN ULTRA is potentially a hazardous activity. I agree not to enter and engage in such activities unless I am medically able and properly trained. I agree to abide by any decision of the event organizers or sports coordinators relative to my ability to safely complete the activities mentioned hereto. I assume all risks  associated with the activities in this event, including, but not limited to: falls, contact with other players, effects of the weather, conditions of the course, and all risks being known and appreciated by me. Having read this waiver and knowing these facts and consideration of you accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Cordillera Conservation Trust Inc. and all its officers, their representatives and successors from all claims and liabilities of any kind arising out of my participation in this event.

I also hereby confirm that the above information is true and correct.

I also grant permission to all for the foregoing to use my name, likeness and identity in any photograph, motion picture, ad or any other record of this event in perpetuity, throughout the world, any media now known or developed later for any legitimate promotional

I have read and understood everything written above.

SIGNED:

______________________________

PLEASE PRINT NAME AND SIGN

DATE: _________________________


MEDICAL CERTIFICATE

I the undersigned _______________________________ Doctor of Medicine, see no reason that the above participant, _____________________________________ on examination, cannot take part in competitive or non-competitive mountain running during the Cordillera Mountain Marathon.

Doctor’s Signature

_____________________________

Date: ___________________________

This document is only valid for one year from the above date.