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IARI "Athletics Day for Kids"2019 - Registration Form (Last Date to Register Sept.23rd,2019)
Event Dates & Timing: September 29th (3PM to 7PM EST), September 30th (5PM to 7PM EST)
Additional Date (if needed): October 1st (5PM to 7PM EST)
Event Address: Johnston High School Athletics Center, 345 Cherry Hill Road, Johnston, RI 02919
Participant Full Name
Parent/Guardian Phone Number
3 to 4 Years (Select 50 mts only)
5 to 7 Years
8 to 10 Years
11 to 13 Years
14 to 15 Years
Activities to Register (Each participant may participate in multiple events)
50 Mts Running (3 to 4 Years must select this Option only)
Waiver & Release Notice RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT (“AGREEMENT”) I acknowledge that athletics is an extreme test of a person’s physical and mental limits and that my participation in this activity can cause potential death, serious injury, or property damage. With a full understanding of the potential risks, I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THIS EVENT. I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns:(a) I WAIVE, RELEASE, AND DISCHARGE from any and all claims or liabilities for death or personal injury or damages of any kind, except that which is the result of gross negligence and/or willful misconduct of the Released Persons listed below, which arise out of or relate to my traveling to and from or my participation in this event, the following persons or entities (collectively, the “Released Persons”): Indian Association of Rhode Island (IARI) and the officers, directors, employees, representatives, volunteers and agents of the above;(b) I AGREE NOT TO SUE any of the Released Persons for any of the claims or liabilities that I have waived, released, or discharged herein; and(c) I INDEMNIFY AND HOLD HARMLESS the Released Persons from any claims made or liabilities assessed against them as a result of my/my child’s actions. I/my child do not have any physical limitations, medical ailments, physical or mental disabilities that would prevent or limit me/my child from participating in this event. If I am under eighteen (18) years of age, my parent or legal guardian has executed this waiver and release on my behalf and hereby binds him or her, myself and all other assigns to the terms of this waiver and release. My parent or legal guardian represents that he or she has legal capacity and authority to act for and on my behalf, and agrees to indemnify and hold harmless the Released Persons for any claims or liabilities assessed against them as a result of any insufficiency of his or her legal capacity or authority to act for and on my behalf in the execution of this waiver and release. My parent or legal guardian fully consents to my participation in this event and authorizes representatives of Indian Association of Rhode Island (IARI) to act for him or her using their best judgment in any situation requiring medical attention for me.I grant to IARI its representatives and employees the right to take photographs of me/my child and my property in connection with the above-identified subject. I authorize IARI its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that IARI may use such photographs of me/my child with or without my name/my child’s name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, web and social media content.
Yes & Agree to Waiver and Release Notes mentioned above
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