WAIVER: This completed form (either signed in person, and/or submitted electronically) represents the legal release of any and all rights and claims for damages or injuries that may arise against the coordinators of the 2nd Annual City Island St. Paddy’s Day 5k, the PTA of P.S. 175, and all of their agents assisting with the event, sponsors and their representatives and employees, namely Lauren Nye, Rose Rodstrom, and Jacqueline Ciarletta.
By signing the form, I agree, for myself and for any minor children on whose behalf I am signing, that I accept all of the risks inherent to a friendly road race, including but not limited to injury to myself or others. I understand that the event will take place outdoors rain or shine. I agree to indemnify and hold harmless City Island Roadies and its officers, directors, and organizers, from any and all damage that I or my minor children may experience as a result of my participation in this race.
The participants covered by this waiver include:
I have spoken to my medical doctor about participating in athletic activities and I have not been advised to restrict or limit my activities in such a way as to preclude my participation in this event.
The adult participant and any children under 18 years being represented by a parent or adult guardian listed in this waiver release any and all claims against the PTA and affiliated parties of the race event, including all possible injuries and/or damages that may be endured before, during or after the event. The participant(s) understand(s) that this release is binding on all accounts.
By signing this waiver, the participant(s) also authorize the use of photographs or videos that include my image for promotional, or informational reasons.
* Sign on both lines if you are an adult participating in the race, and you are signing on behalf of a minor.