P I T D

Panic in the Park PARTICPANT AGREEMENT AND RELEASE DATE OF EVENT: OCTOBER 27, 2012 LOCATION OF EVENT: Hookslide Kelly’s, Shedd Park and Fort Hill. Lowell, Ma I, _________________________________________________________ Participant Name _________________________________________________________ Address _________________________________________________________ Date of Birth in exchange for being permitted to participate in the Panic in the Park (which is called the “Event”), agree and acknowledge as follows (Participant Must be 21+) 1. SmithFest Events and Hookslide Kelly’s LLC (“SFHK” – this means SFHK and its owners, employees, staff, etc.) is conducting an Event called “Panic in the Park” as noted above. I will run, climb, crawl, hurdle, jump, duck, spring and take any other actions to complete a five kilometer (appx.) outdoor race and obstacle course in existing weather, good or bad in the dark. I understand that members of the “Chasers” or “Zombies” may chase me and try to scare me and there may be some incidental contact or bumping. 2. I know the Event activities are potentially dangerous and that I could be injured or even killed, but I accept them anyway and assume all risks (including the inherent danger of the Event; the negligence or intentional acts of any person including myself; inadequate wearing apparel; dangerous ground conditions; spectator interference; natural causes; and all other causes of injury, damage or loss). If I am injured, I will not make any claim against SFHK. I will also indemnify (reimburse) SFHK if any other person makes a claim against it for anything I did. 3. I understand SFHK does not provide medical services or insurance and that my ticket fee is non-refundable and does not include these benefits. 4. I know the Event will be conducted on land not belonging to SFHK, and that because SFHK may not be familiar with any dangerous conditions there, it has no duty to warn me. 5. I will at all times conduct myself in a careful manner, will not injure or damage any other person or property and will obey all laws, Event Rules, and Event Staff (including security personnel engaged by SFHK). I will not while racing be under the influence of any alcohol, drug, or substance nor consume any of these. 6. I do not have any mental, physical, or other health conditions which would make my participation in the Event inadvisable or dangerous. 7. I am not an employee of SFHK and have no rights other than to participate in the Event. 8. If I am injured or have any other type of loss or damage (including theft of personal property), I will not make any claim against SFHK. I will also indemnify (reimburse) SFHK if any other person makes a claim against it for anything I did. 9. I understand that in participating in this event, I give full release of my image to SFHK for promotional purposes. 10. I agree that my being permitted to participate in the Event is adequate consideration for the releases, waivers, and indemnities given herein. SEEN AND AGREED: ________________________________________________ ____________________ Participant/Parent/Guardian Date SecureFeeâ„¢ 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.