Space2Thrive “Space2Thrive Come out and Revive” is a unique event that empowers participants to take action and demonstrate their desire to build stronger, supportive and brave communities, who embrace and celebrate diversity. We are committed to making a difference in the community and that is why we invite YOU to join us on September 14th 2024 for a one of a kind experience running or strolling beautiful West Hill Dam. WAIVER: By submitting this form, you are agreeing to comply with the following terms and conditions, and you certify the information you are providing is complete and correct. You understand and acknowledge that: Space2Thrive Inc, 5K, and all related parties do not assume responsibility for your health, safety, security, or support; the responsibility for medical costs of any kind associated with transport, care, and treatment lies with the participant; you are able to complete the course; you agree to follow all health and safety protocols; you will not compete in a manner which, in the judgment of the race officials, interferes with race operations, other participants, or the integrity of the competition; you will not reproduce, trim, fold or otherwise alter your official bib number, and you will not knowingly assist others in the duplication, replication or alteration of a bib; [_] I acknowledge the conditions listed above and agree to abide by them. [_] I agree that I will follow all protocols and procedures related to COVID- 19 mitigation and public health for the Space2Thrive Inc, 5K including, but not limited to, testing procedures and wearing a face mask. PARTICIPANT'S AGREEMENT, WAIVER, RELEASE AND ACKNOWLEDGEMENT In consideration of your accepting this entry, I hereby, for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for liability and damages I may have against Space2Thrive Inc, 5K, its employees, agents, officers, governors, sponsors, and volunteers, USA Track and Field, the Commonwealth of Massachusetts, and the City of Uxbridge and any other city or town in which the race is contested, and their representatives, successors and assigns, for any and all injuries or death suffered by me in or arising from said event. I acknowledge that it is my responsibility to understand the risks and determine whether I am fit to safely complete this event and the precautions I should take. I attest and certify that my physical condition and ability to safely complete this event have been verified by a licensed medical doctor (except where the latter is in violation of religious principles) and that I am physically fit and have sufficiently trained to complete this event. In addition, I acknowledge the contagious nature of COVID-19 and other communicable diseases and voluntarily assume the risk that I may be exposed to or infected by COVID- 19 and/or other communicable diseases by participating in this event. I acknowledge that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my participation in this event and personally assume this risk. I agree to abide by all rules and guidelines of the Space2Thrive Inc, 5K and not to cover, alter, reproduce, or transfer my running number or alter or transfer my timing on pain of my and my transferee's disqualification from this and future competitions. I further agree to read and abide by the World Health Organization’s (WHO), Center for Disease Control’s (CDC), and/or applicable local authority’s recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases. I grant to the Space2Thrive Inc, 5K and its sponsors and licensees the exclusive right to the free use of my name, voice, and/or picture in any broadcast, telecast, advertising, promotion, or other account of this event. I agree that Space2Thrive Inc, 5K may publish my Personal Information (defined below) as part of the results of the event and may pass such information to the governing body (national or international) or any affiliated organization for purposes such as obtaining insurance, obtaining permits and/or for publishing results either for the event alone or combined with or compared to other similar events. Personal information here may include, without limitation, name, any club affiliation, race times, occupation, town of residence, and age category. If I choose to make a donation to Space2Thrive Inc, I agree that the following information may be shared with the charitable organization: my name, mailing address, email address, and amount donated. I acknowledge that my entry fee is non- refundable, non-deferable, and non-transferable, even if the race is canceled, and that if the race is canceled Space2Thrive Inc, 5K has no obligation to me for any expenses that I may incur pertaining to my planned participation, whether for travel, lodging, meals or any other matter. I agree that any legal claim or dispute arising out of or in any way relating to my participation in this event will be governed by the laws of Massachusetts and will be adjudicated exclusively by and in the Courts of Massachusetts. CONSENT TO TREATMENT In the event of an emergency, I do grant permission to officials of Space2Thrive Inc, 5K to provide onsite medical treatment and, if needed, transport me to a hospital emergency room for medical or surgical treatment. I give full authorization to Space2Thrive Inc, 5K and its medical staff, employees, agents and/or subcontractors to secure medical care or treatment for me. I understand that this may involve collection of medical survey data and other uses of a mobile application in connection with any medical treatment or medical attention provided to me as part of the event. This treatment may include assistance from approved and licensed medical staff providing medical care at the event, the nearest physician, hospital, trained nurse, or EMT in the event of illness or injury that requires immediate attention, as determined by the event staff. I grant to the Space2Thrive Inc, 5K and its medical staff and designees access to my medical records and physicians, as well as other information relating to medical care that may be administered to me due to my participation in this event. I acknowledge and agree that I am responsible for any payments due to any service providers who furnish any such treatment, including emergency medical transport services, and I authorize the Space2Thrive Inc, 5K to provide contact information for me to any medical service provider seeking such payment. GENERAL WAIVER I know that running, volunteering or just being in/at a race/5K/any distance at the Space2Thrive 5K event is a potentially hazardous activity, which could cause injury or death. I will not enter and participate unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I agree to abide by any decision of a race official relative to any aspect of my participation in this event, including the right of any official to deny or suspend my participation for any reason whatsoever. I attest that I have read the rules of the race and agree to abide by them. I assume all risks associated with running/volunteering or being in this event, including but not limited to: falls, physical contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators including the potential the contraction of a communicable disease resulting from contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators. I assume all risks including: the effects of the weather; high heat and/or humidity; freezing cold temperatures; traffic and the conditions of the road including surrounding terrain. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I assume all such risks being known, appreciated, and accepted by me. I understand that bicycles, skateboards, baby joggers/strollers, roller skates or inline skates, animals, and personal music players are not allowed in the race, and I will abide by all race rules. Having read this waiver and knowing these facts and inconsideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Space2Thrive Inc 5K, the city of Uxbridge, MA, and the Road Runners Club of America, all event sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. In addition, I acknowledge the contagious nature of COVID-19 and other communicable diseases and voluntarily assume the risk that I may be exposed to or infected by COVID-19 and/or other communicable diseases by participating in this event. I acknowledge that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my participation in this event and personally assume this risk. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I understand that this event does not provide for refunds in the event of a cancellation, and by signing this waiver, I consent that I am not entitled to a refund if the event is canceled before or during the event. VISITOR’S ACKNOWLEDGEMENT OF RISKS In consideration of the services of Space2Thrive Inc 5K, their officers, agents, employees, and stockholders, and all other persons or entities associated with those businesses (hereinafter collectively referred to as “Space2Thrive”) I agree as follows: Although Space2Thrive has taken reasonable steps to provide me with appropriate information, skilled event directors, and volunteers for Space2Thrive Inc 5K so I can enjoy this activity for which I may not be skilled, and Space2Thrive has informed me this activity is not without risk. Certain risks are inherent in this activity, Space2Thrive Inc 5K, including and cannot be eliminated without destroying the unique character of the activity. These inherent risks are some of the same elements that contribute to the unique character of this activity and can be the cause of loss or damage to my equipment, or accidental injury, illness, or in extreme cases, permanent trauma or death. Spae2Thrive does not want to frighten me or reduce my enthusiasm for this activity, but believes it is important for me to know in advance what to expect and to be informed of the inherent risks. The following describes some, but not all, of those risks: risks of injuries and death. I am aware that Space2Thrive Inc 5K entails risks of injury or death to any participant. I understand the description of these inherent risks is not complete and that other unknown or unanticipated inherent risks may result in injury or death. I agree to assume and accept full responsibility for the inherent risks identified herein and those inherent risks not specifically identified. My participation in this activity is purely voluntary, no one is forcing me to participate, and I elect to participate in spite of and with full knowledge of the inherent risks. I acknowledge that engaging in this activity may require a degree of skill and knowledge different than other activities and that I have responsibilities as a participant. I acknowledge that the staff of Space2Thrive has been available to more fully explain to me the nature and physical demands of this activity and the inherent risks, hazards, and dangers associated with this activity. I acknowledge that I have read information provided by Space2Thrive that is related to the nature and physical demands of this activity and the inherent risks, hazards, and dangers associated with this activity. I certify that I am fully capable of participating in this activity. Therefore, I assume and accept full responsibility for myself, including all minor children in my care, custody, and control, for bodily injury, death or loss of personal property and expenses as a result of those inherent risks and dangers identified herein and those inherent risks and dangers not specifically identified, and as a result of my negligence in participating in this activity. I have carefully read, clearly understood and accepted the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon myself, my heirs, assigns, personal representative and estate and for all members of my family, including minor children. ADDITIONAL ONLINE REGISTRATION WAIVER: – Space2Thrive Inc, 5K By submitting this form, you are agreeing to comply with the following terms and conditions, and you certify the information you are providing is complete and correct. You understand and acknowledge that: Space2Thrive Inc, 5K, and all related parties do not assume responsibility for your health, safety, security, or support; the responsibility for medical costs of any kind associated with transport, care, and treatment lies with the participant; you are able to complete the course; you agree to follow all health and safety protocols; you will not compete in a manner which, in the judgment of the race officials, interferes with race operations, other participants, or the integrity of the competition; you will not reproduce, trim, fold or otherwise alter your official bib number, and you will not knowingly assist others in the duplication, replication or alteration of a bib; [_] I acknowledge the conditions listed above and agree to abide by them. [_] I agree that I will follow all protocols and procedures related to COVID- 19 mitigation and public health for the Space2Thrive Inc, 5K including, but not limited to, testing procedures and wearing a face mask. PARTICIPANT'S AGREEMENT, WAIVER, RELEASE AND ACKNOWLEDGEMENT In consideration of your accepting this entry, I hereby, for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for liability and damages I may have against Space2Thrive Inc, 5K, its employees, agents, officers, governors, sponsors, and volunteers, USA Track and Field, the Commonwealth of Massachusetts, and the City of Uxbridge and any other city or town in which the race is contested, and their representatives, successors and assigns, for any and all injuries or death suffered by me in or arising from said event. I acknowledge that it is my responsibility to understand the risks and determine whether I am fit to safely complete this event and the precautions I should take. I attest and certify that my physical condition and ability to safely complete this event have been verified by a licensed medical doctor (except where the latter is in violation of religious principles) and that I am physically fit and have sufficiently trained to complete this event. In addition, I acknowledge the contagious nature of COVID-19 and other communicable diseases and voluntarily assume the risk that I may be exposed to or infected by COVID- 19 and/or other communicable diseases by participating in this event. I acknowledge that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my participation in this event and personally assume this risk. I agree to abide by all rules and guidelines of the Space2Thrive Inc, 5K and not to cover, alter, reproduce, or transfer my running number or alter or transfer my timing on pain of my and my transferee's disqualification from this and future competitions. I further agree to read and abide by the World Health Organization’s (WHO), Center for Disease Control’s (CDC), and/or applicable local authority’s recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases. I grant to the Space2Thrive Inc, 5K and its sponsors and licensees the exclusive right to the free use of my name, voice, and/or picture in any broadcast, telecast, advertising, promotion, or other account of this event. I agree that Space2Thrive Inc, 5K may publish my Personal Information (defined below) as part of the results of the event and may pass such information to the governing body (national or international) or any affiliated organization for purposes such as obtaining insurance, obtaining permits and/or for publishing results either for the event alone or combined with or compared to other similar events. Personal information here may include, without limitation, name, any club affiliation, race times, occupation, town of residence, and age category. If I choose to make a donation to Space2Thrive Inc, I agree that the following information may be shared with the charitable organization: my name, mailing address, email address, and amount donated. I acknowledge that my entry fee is non- refundable, non-deferrable, and non-transferable, even if the race is canceled, and that if the race is canceled Space2Thrive Inc, 5K has no obligation to me for any expenses that I may incur pertaining to my planned participation, whether for travel, lodging, meals or any other matter. I agree that any legal claim or dispute arising out of or in any way relating to my participation in this event will be governed by the laws of Massachusetts and will be adjudicated exclusively by and in the Courts of Massachusetts. CONSENT TO TREATMENT In the event of an emergency, I do grant permission to officials of Space2Thrive Inc, 5K to provide onsite medical treatment and, if needed, transport me to a hospital emergency room for medical or surgical treatment. I give full authorization to Space2Thrive Inc, 5K and its medical staff, employees, agents and/or subcontractors to secure medical care or treatment for me. I understand that this may involve collection of medical survey data and other uses of a mobile application in connection with any medical treatment or medical attention provided to me as part of the event. This treatment may include assistance from approved and licensed medical staff providing medical care at the event, the nearest physician, hospital, trained nurse, or EMT in the event of illness or injury that requires immediate attention, as determined by the event staff. I grant to the Space2Thrive Inc, 5K and its medical staff and designees access to my medical records and physicians, as well as other information relating to medical care that may be administered to me due to my participation in this event. I acknowledge and agree that I am responsible for any payments due to any service providers who furnish any such treatment, including emergency medical transport services, and I authorize the Space2Thrive Inc, 5K to provide contact information for me to any medical service provider seeking such payment. SecureFee™ Registration Cancellation Insurance is offered in most states. If purchased, your registration may be covered for one of the covered reasons stated in the policy.
