2021 Virtual Dash Sign Up
Please complete the form below to sign up for the virtual Madison Dash.
Your email address:
RELEASE AND INDEMNITY PARTICIPATION AGREEMENT – MADISON DASH TO THE BASH 2021 THIS AGREEMENT AFFECTS YOUR LEGAL RIGHTS TO RECOVERY SHOULD YOU BE INJURED IN THIS EVENT. PLEASE READ IT CAREFULLY. This release and indemnity participant agreement is a requirement for participation in this event and I understand without acknowledging I have read and agree to its terms, I will not be allowed to participate. I also understand that this is a requirement for any participant I may register and that they will also be required to read and agree to its terms before being allowed to participate excluding when registering my minor child where I must be the legal parent or guardian, must read and agree to its terms for my child and understand my child will not be allowed to participate unless I have done so. In consideration of your accepting my entry into this race event, I, the undersigned, do hereby for myself, my personal representatives, assigns, heirs, executors, administrators and successors, fully and forever waive, release, discharge any and all rights and claims for damages I may acquire against the Madison School District, the beneficiaries, all partners, sponsors, cosponsors, hosts, cohosts, all vendors or individuals related to the event, underwriters, advertisers, the City of Phoenix, Maricopa County, the State of Arizona, all municipal agencies or private parties whose property and/or personnel are used or in any way assist the event and all nonprofits associated with the event, together with their officers, directors, shareholders, representatives, assigns, executors, administrators and successors for loss(es), damages(s) and claims therefor on account of all injuries suffered by me or my property or my resultant death caused by participation in the event (“losses”), and further covenant not to sue any of the aforementioned parties for such losses. Furthermore, I am fully aware of the risks and hazards inherent in participating in this event and elect to voluntarily participate. As a condition of participation in the event, I assume all risks associated with my participation in the event and represent and warrant to the releasees that I am in good physical condition and able to safely participate in the event. I hereby grant any medical directors, medical companies or medical company employees of the event, and their agents, affiliates and designees, access to all medical records and physicians as needed and authorize medical treatment as needed. I understand I have the right to refuse medical treatment. I understand that if my medical condition becomes such that my mental capacity is questioned, the event medical director(s) or medical company employees have the right to recommend and initiate treatment. I also understand and agree to assume liability for any and all medical expenses incurred as a result of my participation in the event. I hereby grant full permission to any and all of the foregoing to use my name and likeness in any broadcast, telecast, video, or print media of the event (including for advertising or sales and promotional purposes) without compensation to me and hereby waive and release any claim or right I may otherwise have arising out of such use, publication or distribution. I am fully aware and agree that theMadison School District, in its sole discretion, may delay or cancel this event as it deems necessary, including if it believes the conditions on the day of the event are unsafe. Furthermore, I am aware if the event is delayed or cancelled for any reason, whether or not within the control of the Madison School District, there shall be no refund of the race entry fee or any other costs incurred by me in connection with the event. I am fully aware and agree race entries are nontransferable into another year or event, that I may transfer my race entry to someone else or update personal information in my race entry only when going through the approved process, as indicated on
website, for which I have familiarized myself with the process. I am aware that I must allow ample time for any change needing to be made to my race entry on race day and that the Madison School District will not accept any responsibility or liability for delays preventing a change from being made for any reason and will not hold up any scheduled event for pending changes. I am fully aware and agree if my individual start time is more than15 minutes after gun time, I will forfeit any award recognition, any offered prizes, my individual race result(disqualification) and may not be allowed to participate in the event and that if my individual finish time is more than 15minutes after the allotted time to finish the event, I will forfeit any award recognition, any offered prizes and my individual race result (disqualification). I understand I must cross the finish line to claim any finisher award and I must collect it at the time of crossing to prevent forfeiture. I understand, should I place, I must be present at the award ceremony to claim my placement award and any offered prize and I must collect it when called to prevent forfeiture. I am fully aware and agree I must manage the information contained within my race entry, that I am responsible for validating the information contained within my race entry is correct and accurate and that I must validate the information contained in my registration confirmation, on my bib at packet pickup when applicable and in my individual race result upon completing the race. Furthermore, I am aware I must take the appropriate action to correct any inaccurate information in my race entry by completing a change request as indicated on the
website, for which I have familiarized myself with the process, or in my individual timing result at the timing station upon completing the race prior to the finalization of results and the start of the award ceremony. I understand, dependent on the nature of an individual race result discrepancy, an error may not be able to be corrected after race results are finalized and may cause disqualification of my individual race result and, when applicable, forfeiture of any award recognition or offered prizes. I understand, if results are finalized and I need assistance with a discrepancy in my individual timing result, I may send a request to
for help determining what if any action can be taken. I have had sufficient opportunity to read this entire document and I read, understand it and intentionally and voluntarily accept and agree to be bound by its terms. Furthermore, I warrant all statements made herein are true and correct and understand that releasees have relied on them in allowing me to participate in this event.
I have read and agree to the terms and conditions of the release and indemnity participation agreement.
By entering my email address I agree to receive email communications regarding the Madison Dash and Wellness Bash events.
Never submit passwords through Google Forms.
This form was created inside of Madison Elementary School District.