2018 Health First Mayors' Fitness Challenge Registration
Registration Timeline: MFC Registration will remain open until April 28, 2018.

Waiver of Liability

United Way of Brevard, its Affiliate Groups and all Brevard County Municipalities

WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT

In consideration for participation in the Mayors’ Fitness Challenge, I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE United Way of Brevard or Health First, any of its affiliate members and any city in Brevard County, from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, while participating in any physical activity related to the Challenge I understand that I should consult my physician before engaging in any physical activity particularly if I have any preexisting condition which could be harmful to me while engaging in physical activity.


By checking this box, I understand and agree to all terms in this waiver. *
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Tobacco Use
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Do you currently use tobacco?
If yes, are you currently participating in a tobacco cessation program?
Are you interested in learning more about tobacco cessation programs?
A note on your privacy - All information collected from you is used by United Way of Brevard and Health First for the purposes of the 2018 Health First Mayors’ Fitness Challenge and will NOT be disclosed or sold to a third party.
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