Walk-a-thon Registration Form
Event: Walk in the Park Walk-a-thon @ Matzke Park on Grant and Copeland Street.
When: Saturday June 25, 2016 7:00 AM Registration 8:00 Walk begins
Registration Fee: $10.00 Individuals; $20.00 Family
Please fill out this registration form and waiver for each person walking in the event.
All proceeds go towards the Faith Forward campaign!
City: ___________________________State: ________ Zip:____________
Telephone: ________________ Email: _______________________________
Payment method: Cash Check # __________
For more information please contact Patricia Tatum at email@example.com.
It is my understanding that being permitted to participate in any First Metropolitan Church sponsored event and/or activities, for myself, my personal representatives, assigns, heirs and next of kin, I agree and understand that the nature of a Walk-a-Thon and that I am qualified to participate in this activity. I fully acknowledge that the activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of traveling are to be expected, I fully agree and understand that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in this activity.
I understand that participating in this activity entails inherent risks of physical injury. I FULLY ACCEPT AND ASSUME ALL SUCH RISK AND ALL RESPONSIBILITY FOR LOSSES, COST AND DAMAGES I incur as a result of my participation in this activity.
I hereby release discharge, covenant not to sue, and agree to indemnify and save and hold harmless First Metropolitan Church and their representatives, directors, agents, and employees. Other participants, any sponsors, advertisers, and if applicable, CLAIMS, DEMANDS LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEDGED TO BE CAUSED IN WHOLE OR PART BY THE NEGLIGENT RESCUE OPERATIONS.
I have read this agreement, fully understanding its terms, understanding that I have given up substantial rights by signing it and have signed freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, not withstanding, shall continue in full force and affect.
I have read and signed the attached release form __________ Yes _____________ No