DeSena Dash 5K

Waiver (Please read carefully) I, ________________________________________, know that participating in the DeSena Dash 5K is a potentially hazardous activity. I understand that a 5K race is a physically strenuous activity, and that participating in the activity may result in various types of bodily injury, sickness, emotional injury, heart attack and death. I represent that I am aware of the health risks associated with the activity and that I am medically able and properly prepared to participate in the event. I assume all risks associated with this event, which can include but are not limited to, health risks, falls, and contact with other participants, road conditions, traffic, and weather such as heat, cold, wind, humidity, rain, ice or snow. I, on behalf of myself, my heirs, assigns, executors, and personal representative hereby waive and release Greene-Hills School, Bristol Board of Education, the City of Bristol and Forestville, race officials, volunteers, sponsors and any other race-related persons from claims of any kind arising out of my participation in this event, including but not limited to death, injury, damages, expenses or losses sustained during, or received as a result of participation in this event. I also hereby grant permission to all of the above to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. ___________________________________________________________________Date__________________ Signature of Participant (Parent’s signature required if under 18 years of age) 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.