Registration for Summer Running 2019
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Student Athlete Last Name *
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Student Athlete First Name *
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Student Athlete grade in fall 2019 *
Student Athlete phone number (optional)
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Student Athlete email (optional)
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Parent #1 full name *
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Parent #1 phone number *
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Parent #1 email address *
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Emergency contact/parent #2 full name *
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Emergency contact/parent #2 phone number *
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Emergency contact/parent #2 email (optional)
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Please read the behavioral contract below. In order to participate in summer running, each student athlete and a parent must sign this agreement. A hard copy of this will be available at the meeting and on the first day of running. Washburn Running Club Summer Program 2019 Behavior Expectation Contract 1) We are representatives of our Club, our families, Washburn High School, and our community. As such, we conduct ourselves as a group and individuals in a respectful and appropriate manner. We use appropriate language at all times. We are courteous to other runners and neighbors. We use common sense when choosing our running courses and yield to pedestrians and vehicles. 2) We communicate proactively with coaches, parents, and other athletes. Important areas for communication include, but are not limited to: Attendance, Injuries, Missed or Skipped Workouts 3) Our goal is to improve the fitness and performance of all athletes involved in our club. We strive to support each other in a constructive way in our efforts. When we work together, we all get better. 4) Bullying is NOT allowed in any form. Any reports will be treated seriously and addressed, up to and including dismissal from the program. 5) We follow the guidelines established by the MSHSL regarding the illegal use of alcohol and drugs. Any confirmed use of alcohol, illegal drugs, pharmaceuticals, tobacco, or electronic cigarettes will be cause for immediate dismissal from the Washburn Summer Running Program. Signed and agreed by the student athlete and parent. By typing in the athlete and parent names below, you are signing. *
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Please read the following liability release form. In order to participate, each athlete and one parent must sign this release. A hard copy of this will be available at the meeting and on the first day of running. Washburn Running Club Summer Program 2019 Liability Release Read Carefully Before Signing I understand that running and related activities involve many RISKS, DANGERS, and HAZARDS. These risks, dangers, and hazards include, but are not limited to, falling, colliding with people or natural or man-made structures, damage to property, and equipment failure. I understand that DAMAGE TO PERSONAL PROPERTY and INJURIES OF ALL TYPES ARE A COMMON AND ORDINARY OCCURRENCE of running and related activities.I also know that the risk of SEVERE INJURY and even DEATH exists when I run. Personal training, coaching, instruction, supervision and enforcement of rules by the Washburn Running Club, its subsidiaries, affiliates, officers, directors, volunteers, employees, coaches, contractors and representatives, competition organizers and sponsors, and facility operators (hereinafter the term “WRC” shall be used to refer to all such persons and entities collectively) do not and cannot guarantee my safety. I also understand that participation in these Activities involve physical exercise and that I should and am herein advised to consult with a physician before beginning or continuing with this or any other physical exercise program. With full knowledge and understanding of the RISK OF SEVERE INJURY AND DEATH involved in running, I FREELY AND VOLUNTARILY ACCEPT AND FULLY ASSUME THE RISK THAT I MAY SUFFER TEMPORARY, PERMANENT OR EVEN FATAL INJURIES AND DAMAGE TO PERSONAL PROPERTY, even if I follow the instructions or advice of WRC. In partial consideration of WRC’s acceptance of my registration to participate in WRC, and in spite of the risk of severe or permanent injury, or even death or damage to personal property the undersigned (hereafter ‘athlete”) agrees to comply with and be bound by the following terms at all times while affiliated with WRC whether training or in competition: 1. Athlete hereby unconditionally WAIVES and RELEASES ANY AND ALL CLAIMS, AND AGREES TO HOLD HARMLESS DEFEND AND INDEMNIFY WRC and any and all of its sponsors FROM ANY CLAIMS, present or future, to Athlete and his/her property, or to any other person or property, for any loss, damage, expense, or injury (including DEATH), suffered by any person from or in connection with Athlete’s participation in any activities in which WRC is involved in any way, due to any cause whatsoever, INCLUDING NEGLIGENCE or otherwise, and /or breach of express or implied warranty on the part of WRC. 2. Athlete hereby RELIEVES WRC OF ANY DUTY TO PROTECT ATHLETE FROM HARM in connection with any Activities in which WRC is involved in any way. 3. Athlete authorizes WRC to obtain medical care for, or transport him/her to a medical facility or hospital if, in the opinion of WRC, medical attention is required and Athlete is unable to make such decision for himself/herself. Athlete agrees to pay all costs associated with such medical care and related transportation and shall DEFEND, INDEMNIFY, AND HOLD HARMLESS WRC of and from the consequences of such decision and from any such costs incurred relating to the provision of medical care. 4. This Agreement shall be construed in accordance with, and governed by the substantive laws of, the State of Minnesota, without reference to principles governing choice or conflicts of laws. In addition, Athlete agrees that all lawsuits for personal injury or related loss against WRC must be maintained in state courts sitting in Hennepin County, Minnesota, or federal district courts sitting in the District of Minnesota, and Athlete consents and agrees that jurisdiction and venue for such proceedings shall lie exclusively with such courts. In the event any portion of this release is found to be unenforceable, the remaining terms shall be fully enforceable. 5. Athlete acknowledges and agrees that the provisions of this Agreement are clear and understandable to him/her and that he/she fully appreciates and understands the meaning of the terms of this Agreement and their effect. HAVING CAREFULLY READ THE FOREGOING AND UNDERSTANDING IT TO BE A LEGALLY BINDING RELEASE AND INDEMNITY AGREEMENT, ATHLETE SIGNIFIES HIS/HER ASSENT TO THE ABOVE TERMS BY SIGNING BELOW: Please type the name of the student athlete and parent below. By entering the athlete and parent names below, you are signing and agreeing to this release form. *
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Today's date *
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Once you click on the submit button, a link will appear allowing you to make the suggeted donation of $75. Please direct any questions to washburnxc@gmail.com The summer info meeting will be Wednesday May 15. First day of summer running will be Tuesday June 18th. Thank you very much!!
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