FG / LTSF Up & Running Program Registration (Fall 2017)
Thanks for your interest in training for the Up & Running Program! Participants will train on Mondays and Fridays starting August 31st - October 1st from 2:45-3:45. The race will be October 6th (Indianapolis Half 5k). I've invited you to fill out the form FG / LTSF Up & Running Program Registration (Fall 2018).
¡Gracias por su interés en entrenar en el programa de Up and Running! Los participantes van a entrenar los lunes y los viernes. Empezamos el 31 de agosto hasta el 1 de octubre de 2:45-3:45. La carrera es el 6 de octubre (Indianapolis Half 5k). Por favor, rellenen el formulario FG / LTSF Up & Running Program Registration (Fall 2018). Para hacerlo visite:
Runner's First Name *
Your answer
Runner's Last Name *
Your answer
Runner's Homeroom Teacher/ Maestra de su hijo/a *
(If runner is an adult, mark "Adult Runner." Training is open to grades four, five, and six as well as siblings in grade two and three.)
Your answer
Runner's Age/ Edad *
Your answer
Gender *
T-Shirt Size/ Talla *
Street Address/ dirección *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Race option: *
Parent's/Guardian's First Name *
Your answer
Parent's/Guardian's Last Name *
Your answer
Parent's/Guardian's E-mail Address *
Your answer
Parent's Mobile Phone *
(###) ###-####
Your answer
Volunteering:
Emergency Contact's Name *
(First / Last)
Your answer
Emergency Contact's Mobile Phone *
(###) ###-####
Your answer
If runner is a younger sibling of an older participant, what is the older sibling's name?
Your answer
Performance options *
WARNING: READ THIS PROGRAM/EVENT WAIVER AND RELEASE OF LIABILITY AGREEMENT (THE "AGREEMENT") CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF LEGAL RIGHTS. BE AWARE THAT BY EXECUTING THIS AGREEMENT AND PARTICIPATING IN THIS PROGRAM/EVENT, YOU WILL BE EXPRESSLY ASSUMING THE RISK AND LEGAL LIABILITY, AND WAIVING AND RELEASING ANY CLAIMS FOR INJURIES, DAMAGES, OR LOSS WHICH YOU MIGHT SUSTAIN AS A RESULT OF ANY ACTIVITIES CONNECTED WITH PARTICIPATION IN THE PROGRAM/EVENT. DO NOT SIGN THIS AGREEMENT UNLESS YOU HAVE READ IT IN ITS ENTIRETY. SEEK THE ADVICE OF LEGAL COUNSEL IF YOU ARE UNSURE OF ITS EFFECT. Warning of Risks and Assumption of Risks. Participation in the Program/Event may challenge and engage your physical and mental resources. You should not participate in the Program/Event if you have any health conditions affecting your ability to participate. You should seek advice from your physician before participating in the Program/Event. There is always a risk of injury when participating in exercise activities and, understandably, not all hazards and dangers can be foreseen. Participation in the Program/Event may involve inherent risks, dangers and hazards, which h may occur without warning, or be due to poor skill level, lack of conditioning, carelessness and other unforeseen, unidentified or unexpected perils inherent in physical activities. By execution of this Agreement, I acknowledge that I understand the risk and danger of accidents, physical injury, effects of exercise, and the unpredictable nature of the human body and the activities inherent in the nature of the Program/Event. I acknowledge that I am a voluntary participant in this Program/Event, and in good physical condition. I further acknowledge that physical exercise and participation in this Program/Event will challenge and engage my physical resources. I have either visited with my physician and received doctor's advice and consent to my exercise program or have waived such advice and consent of my doctor, and accept any and all risks. Waiver, Release and Indemnification. I UNDERSTAND AND ACKNOWLEDGE THAT NEITHER THE SPONSOR NOR ANY OF ITS AFFILIATES ARE INSURERS OF MY CONDUCT AND SAFETY. I KNOW THAT THIS EVENT IS A POTENTIALLY HAZARDOUS ACTIVITY AND I HEREBY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR ANY INJURY OR ACCIDENT WHICH MAY OCCUR DURING MY PARTICIPATION IN THIS EVENT. TO THE FULLEST EXTENT PERMITTED BY LAW, I HEREBY RELEASE, WAIVE, HOLD HARMLESS AND COVENANT NOT TO FILE SUIT AGAINST THIS EVENT, THE SPONSOR AND ANY AFFILIATED INDIVIDUALS OR ENTITIES ASSOCIATED WITH THIS PROGRAM/EVENT (INCLUDING ALL TRUSTEES, DIRECTORS, MANAGERS, OFFICERS, EMPLOYEES, VOLUNTEERS, AGENTS AND REPRESENTATIVES OF THE SPONSOR) (THE "RELEASEES") FROM ANY AND ALL LOSSES, DAMAGES, LIABILITIES OR OTHER CLAIMS AND CAUSES OF ACTION WHATSOEVER THAT I MAY HAVE ARISING OUT OF MY PARTICIPATION IN THIS EVENT, INCLUDING PERSONAL INJURY, DEATH OR DAMAGE SUFFERED BY ME, MY PERSONAL PROPERTY OR OTHERS, WHETHER THE SAME BE CAUSED BY FALLS, CONTACT WITH OTHER PARTICIPANTS, CONDITIONS OF THE COURSE, NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I AGREE THAT, IN THE EVENT ANY PERSON BRINGS ANY CLAIM OR ACTION INDIVIDUALLY OR ON MY BEHALF, RELATED TO ANY INJURY OR LOSS SUFFERED BY ME AS A RESULT OF MY PARTICIPATION IN THE EVENT, THAT I WILL INDEMNIFY THE RELEASEES AGAINST SUCH CLAIMS, INCLUDING THE PAYMENT OF ATTORNEY FEES. I AGREE THAT THIS AGREEMENT SHALL BIND MY GUARDIAN, ASSIGNS, HEIRS, ADMI NISTRATORS AND EXECUTORS FOREVER. I understand that this Waiver and Release may be stored electronically and agree that a copy is authentic and admissible as evidence in any future dispute or proceedings. If I do not follow all the rules of this Program/Event, I understand that I may be removed from the Program/Event. I give my full permission to this event and their sponsors and corporate sponsors to use any photographs, videotapes or other recordings of me that are made during the course of this Program/Event. *By signing this form, I give permission for my son/daughter to participate in the Up and Running program, which includes practices, running events, and all related activities. Furthermore, I hereby give my permission to my child’s Teacher and/or Mentor to sign as guardian on the entry form of events in which Up & Running will be participating. Your electronic signature below signifies you have read, agreed to, and completed this registration and the included waiver(s). *
(PARENT'S First & Last Name - Must be over 18 years old.)
Your answer
Dated e-signed: *
(today's date)
MM
/
DD
/
YYYY
Registration Payment Acknowledgement: *
I understand that runners will commit to training two days a week after school with adult leaders until 3:30pm on Mondays (transportation is the responsibility of the parent/family). *
Required
I understand that runners will commit to one additional day of cardio exercise during the week (on your own), as required by the LTSF Up & Running training program. *
Required
After clicking "submit" below, I will sign and print the confirmation page before returning it with payment to Sra. Benitez or my child's teacher. *
Required
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