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4th Annual Burden Games Team Registration
This form and payment are mandatory to participate as athletes in the 2017 Burden Games.

Hosted by CrossFit Morgantown to benefit United Way of Monongalia and Preston Counties

Date: Saturday, May 6, 2017
Time: Mandatory day-of registration will be 7 - 7:45 a.m. for all athletes
Location: CrossFit Morgantown (1065 Greenbag Rd. Morgantown, WV 26508)

ONLINE REGISTRATION DEADLINE: Wednesday May 3, 2017; 10 p.m.

Fees:
$120 per team (Includes tee shirt and welcome bag. 100% of proceeds to benefit United Way of Monongalia and Preston Counties. Please submit entry by Friday, March 31 to guarantee tee shirt size.)

Day-Of Registration Fee - $130 per team (This will be on a first-come, first-serve basis determined by team number limit. Cannot guarantee a spot or tee shirt size.)

Waiver & Release from Liability
BOTH athletes participating on the team must read and agree to the following terms and conditions.
I have requested the use of the facility and/or equipment, or the purchase or provision of lessons, instruction, competition participation and/or training including WODs and strength workouts which may include but not limited to weightlifting, powerlifting, Strongman training(stone lifting, farmer’s walk, yoke, kegs, log, axle), Olympic lifting, Mixed Martial Arts, gymnastics, plyometrics, calisthenics, running, swimming, rowing, biking, climbing, jumping, throwing, diet, nutrition, injury prevention, and/or activities incidental thereto individually and collectively ("CrossFit Activities”) and the use of equipment and facility at “CrossFit Morgantown” at 1065 Greenbag Road, Suite A, Morgantown, WV 26508, and/or any public or private location (collectively “Facilities and Equipment”). I understand and acknowledge that serious disabilities, illness (to include “exertional rhabdomyolysis”), death, accidents and injuries can occur during CrossFit Activities at the Facilities and/or through the use of the Facilities and Equipment in which those CrossFit Activities are held, whenever or however they occur and for such period said activities may continue. I further understand and acknowledge that attending, participating in, volunteering at or spectating at CrossFit Activities may require me to perform strenuous activities, or to be exposed to activities, conditions, individuals, equipment or events which have potential to cause death, illness, serious injury, disability, or property loss. Knowing the risks inherent in, and connected with these CrossFit Activities, conditions, equipment or events, and with the full understanding of the activities I will be performing, on behalf of myself, my executors, administrators, heirs, successors, assigns, and next of kin, I HEREBY FULLY ASSUME THE RISKS OF INJURY, ILLNESS, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY INHERENT IN, AND/OR IN ANY WAY CONNECTED WITH, ATTENDING, PARTICIPATING IN, AND SPECTATING A CROSSFIT INTENSE EVENT OR OTHER CROSSFIT ACTIVITY AT THE FACILITIES EVEN IF ARISING FROM THE NEGLIGENCE OF OTHER PERSONS EXECUTING A SIMILAR WAIVER AND RELEASE FROM LIABILITY.I understand that I will not be permitted to Participate in CrossFit Activities without executing this Waiver and Release. As a condition of my Participation in CrossFit Activities, I grant CrossFit Morgantown, and its employees, members, partners, officers and agents perpetual and non-revocable permission to use my name, photographs and video in which my image and likeness appears in connection with my Participation in CrossFit Activities and further grant permission to display, publish, distribute, use, print and reprint such images and likeness, and the right to employ such images or likeness in advertising and promotions relating thereto or to CrossFit Morgantown, or any Activities at or related to CrossFit, including any advertisements or media and electronic displays and transmissions thereof (herein “Likeness Rights”). I release CrossFit Morgantown and its employees, members, partners, officers and agents from any and all liability for damages for use in any manner or media of the Likeness Rights, and waive any and all claims and causes of action for damages for use of the Likeness Rights, including but not limited to: unauthorized use of my likeness, image, character or persona; violation of my right of publicity or privacy; and for copyright or moral rights infringement, defamation, or being cast in a bad light.I understand and agree that this Agreement is a full and final release covering all known and unknown and unanticipated injuries, debts, claims or damages to him/her that have arisen or may have arisen from any matters, acts, omissions or dealings released in this agreement, including but not limited to the use of the photographs and Likeness Rights. The undersigned acknowledges that he/she is aware that he/she may hereafter discover facts in addition to, or different from, those which he/she now knows or believes to be true, but it is his/her intention hereby, fully and finally and forever, to settle and to release any and all matters, disputes and differences, known or unknown, suspected or unsuspected, that do now exist, may exist or heretofore have existed with respect to those matters described herein. I expressly waive and relinquish any and all rights or benefits that I may now have, or in the future may have as to these matters released herein, under the terms of the West Virginia Civil Code and any similar law of any state or territory of the United States.By signing below, the undersigned also waives any and all rights he/she may have, independently or on my behalf, in connection with my image or likeness on such photograph(s) and Likeness Rights, and consents to, joins with and ratifies all grants of permission, waivers, discharges and releases set forth herein above.I KNOWINGLY RELEASE, INDEMNIFY, HOLD HARMLESS, AND DISCHARGE the following persons and entities: Owners and/or Tenants of 1065 Greenbag Road, Suite A, Morgantown, WV 26508; CrossFit, Inc.; CrossFitMorgantown; and the officers, members, directors, employees, representatives, independent contractors, family members, and agents (“Releasees”) of any and all of the above in connection with any claim arising from or in any way connected with my Participation in CrossFit Activities at the Facilities and/or use of the Equipment, whenever or however they occur and for such period said activities may continue. I AGREE NOT TO BRING ANY CLAIM AGAINST RELEASEES, which claims concern in any way death, injury, damage, or loss of any type or nature, which arise out of, are related to, or are in any way connected with attending, participating in, volunteering at or spectating at CrossFit Activities, and/or which arise out of or are connected in any way with my use of, or my presence at the Facility(ies) at which (those) activities held, whether injury, death or disability, loss or damage is caused in whole or in part by negligence, gross carelessness, or other acts or failure to act of those persons or entities.I HEREBY AFFIRM AND ACKNOWLEDGE THAT I HAVE READ THIS DOCUMENT. I HEREBY AFFIRM AND ACKNOWLEDGE THAT I UNDERSTAND ITS CONTENTS AND AGREE TO BE BOUND THEREBY. IF I AM UNDER THE AGE OF EIGHTEEN YEARS, MY PARENT/GUARDIAN HAS READ AND COMPLETED THE SECTION BELOW.PARENTAL CONSENT AND RELEASE(for participants age 17 and under)The undersigned parent/natural/legal guardian hereby executes the foregoing Waiver and Release on behalf of the minor named herein. I hereby bind myself; the minor named herein, his/her executor, administrators, heirs, successors, assigns, and next of kin, to the terms of this Waiver and Release. I represent that I have the legal capacity and authority to act for, or on behalf of, the minor named herein. I agree to indemnify and hold harmless the persons and entities named herein from any claims and liabilities, which may be assessed against them as a result of, or arising out of my legal capacity or my authority to act for and on behalf of the minor named herein in the execution of the Waiver and Release or my execution of the Waiver and Release.Express assumption of risk: I am aware that there are significant risks involved in all aspects of this CrossFit competition. These risks include, but are not limited to: falls which can result in serious injury or death, injury or death due to negligence on the part of myself, or other people around me, injury or death due to improper use or failure of equipment. I am aware that any of these above mentioned risks may result in serious injury or death to me. I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in or attendance at the 4th Annual Burden Games. I have no physical impairments or illnesses that will endanger myself or others. Termination: CrossFit Morgantown reserves the right to terminate any athlete, volunteer or spectator's participation in the 2017 Burden Games at any time, with no further obligation or duty to such athlete. Reasons for disqualification may include, BUT ARE NOT LIMITED TO, any of the following non-exhaustive examples: taunting another competitor or other unsportsmanlike behavior, any actions the evince an intent to cheat or circumvent the rules or intent of the Rules of the Burden Games, and any conduct in violation of West Virginia law. This list is not exclusive or exhaustive and is meant as a guide to competitors, not as a limitation on CrossFit Morgantown’s rights to run the Burden Games in the manner it sees fit. Images: Spectators and participants grant CrossFit Morgantown and persons authorized by them, permission to take pictures and movies of me and use them on their website and other promotional and educational materials without compensation to me. Images obtained by me will not be used for any commercial purpose without prior written consent of CrossFit Morgantown. Severability: If any provision of this Agreement is held in whole or in part to be unenforceable for any reason, the remainder of that provision and of the entire Agreement will be severable and remain in effect. I have read and understood the foregoing and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by me. I understand that by signing this form I am waiving valuable legal rights.
Required
Team Name
Team Division
Athlete #1 Name (Full Name)
Athlete #1 Email
Athlete #1 Phone Number
Athlete #1 Address
Athlete #1 Tee Shirt Size (Must submit by Friday, March 31 to guarantee requested tee shirt size.)
Athlete #2 Name (Full Name)
Athlete #2 Email
Athlete #2 Phone Number
Athlete #2 Address
Athlete #2 Tee Shirt Size (Must submit by Friday, March 31 to guarantee requested tee shirt size.)
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