Walk for Water 2020
September 12th 3pm - 6pm. Shirts are $10 Adults and $5 for U12
Last name *
Your answer
First name *
Your answer
Email *
Your answer
Total number of shirts
Your answer
Adult Small
Adult Medium
Adult Small
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
Waiver *
Makah Water for All recommends that participants obtain a physical examination from a doctor prior to participating in any activity or event. Inconsideration of being allowed to participate in the WELLers Walk, the participant and his/her parent(s) and/or legal guardian(s) understand and agree, on behalf of themselves and also their minor child, to the following: 1. That my participation might result in serious injury, including permanent disability or death, and may further result in other nonphysical injuries such as lost wages and loss of earnings capacity. 2. I recognize that while particular rules, knowledgeable event staff, and personal discipline may reduce these risks, these risks still exist even when these activities are conducted in accordance with all such rules. 3. I recognize that such risk may be due to not only my own actions, but also the action, inaction, or negligence of others, and the condition of the course event. 4. I recognize that there may be other risks that are not known to me or to others or are not reasonably foreseeable at this time. 5. I assume all such risks, both known and unknown, and responsibility for any losses and/or damages resulting form my participation in orbservation of any activity or event. 6. I understand the nature of the activity, I certify that i am in good health and in proper physical and mental condition to participate in such an activity. 7. I grant permission, in the case of an injury, to allow any licensed medical personnel to perform any accepted medical procedure deemed necessary and agree to bear the expense of any such treatment. 8. I agree that I have current and valid health insurance covering these risks. 9. I release, waiver, discharge, hold harmless, covenant not to sue, and agree to indemnify, Makah Water for All, affiliated organizations and participants, and their agents, and the owner of the course, from any and all liability to undersigned, his or her heirs and next of kin from any all claims, demands, losses, and damages which may be sustained and suffered on account of injury, including death or damage to property,caused or alleged to be caused in whole or in part by the negligence of the aforementioned parties. 10. I grant Makah Water for All, and their agents’ full rights to use my photograph, image, likeness, and voice for the promotion, in any manner, of Makah Water for All without the expectation of reimbursement. This shall be deemed consent under Wisc. Stat.995.50(2). 11. With respect to any minor, I certify that my child, being under the age of 18, has my permission to attend and participate in the WELLers Walk.I understand all that is expressed in this agreement, and certify that I am of sound judgement and legally competent to sign this agreement.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy