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Performance AR Series entry fees must be sent with completed entry
form. Each member's information must be completed on the Team application.
Each competitor must sign and turn in a completed Performance
Multisports ACKNOWLEDGMENT OF RISK,
RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT,
(either by mail to Performance Multisports or at the Team Meeting before the
race) to participate in the race under the terms of our
sanction and insurance.
Enter by mail using the online, printable Entry Form -- CLICK HERE.
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Performance Multisports -- Race Waiver &
Release
Complete and return
this form on race day to Performance Multisports race officials prior to start
of event. |
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PRINT NAME |
______________________________________________ Age _____ Gender
________ TEAM ________________________________ |
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E-MAIL
(IMPORTANT) |
__________________________________________________________________________________
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ADDRESS |
___________________________________________________________________________________
Phone (h) _____________________ |
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CITY |
__________________________________________________ State ______
Zip ________________ Phone (w) ______________________ |
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ACKNOWLEDGMENT OF RISK, RELEASE OF
LIABILITY AND INDEMNIFICATION AGREEMENT |
| In
consideration of the acceptance of my application for entry in the
Race by Performance Multisports -- its agents, owners, officers,
volunteers, participants, employees, race organizers, sponsors, and
all other persons or entities acting in any capacity on their behalf
(hereinafter collectively Performance Multisports"), I hereby agree
to release and discharge Performance Multisports on behalf of
myself, my parents, heirs, assigns and my estate as follows. I
hereby freely agree to make the following contractual
representations and agreements. |
| I
acknowledge that any racing is inherently dangerous. I fully realize
the dangers of participating in competitive races, and fully assume
the risks associated with such participation, including but not
limited to the following dangers: dehydration, hyperthermia,
hypothermia, hyponatremia, drowning, collision with pedestrians,
vehicles, and other racers and fixed or moving objects, sliding down
hills, falling from rope obstacles, dangers arising from other
surface hazards, equipment failure, inadequate safety equipment,
weather conditions, insects, animals, the possibility of serious
physical and/or mental trauma and injury, including death. There is
a possibility of being jolted, jarred, bounced, thrown to and fro,
and shaken about. |
| I
understand that there are more hazards than are enumerated here, and
that there are unknown and unforeseeable hazards. I engage in the
activity of this race with knowledge of the inherent risks of
injury. Participation may involve encounters with environmental
dangers or conditions, such as sudden storms, lightning, hail,
falling or rolling rocks, unstable ground or sand, sun, and
saltwater. Changing weather conditions and exposure to the elements
can be uncomfortable and/or harmful, and this exposure could cause
sunburn, dehydration, heat exhaustion, heatstroke, hypothermia, and
heat cramps or fatigue. |
| I hereby
waive, release and forever discharge myself, my heirs, executors,
administrators, legal representatives, assigns and successors in
interest (hereafter collectively ‘successors’) any and all rights
and claims which the host organization, the promoter, the race
director and any sponsors and their boards of directors, property
owners, law enforcement agencies, all public entities, special
districts, and properties (and their respective agents, officials,
and employees) through or by which the event will be held for any
and all damages which may be sustained by my participation in and of
association with the event, or travel to or return from the event,
including such claims which allege negligent acts. |
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I am ultimately responsible for my own
safety. I understand the need for me to make choices that ensure my
safety, regardless of any race instructions. I agree it is my sole
responsibility to be familiar with the race course, the rules of any
sanctioning body, and the special regulations of the event. I
understand and agree that situations may arise during the race which
may be beyond immediate control of Performance Multisports, the race
officials or organizers, and I must act so as to endanger neither
myself nor others. I accept responsibility for the conditions and
adequacy of my equipment and training. I have no physical or mental
condition which, to my knowledge, would endanger myself or others if
I participate in this event, or would interfere with my ability to
participate in this event. |
| I agree,
for myself and successors, that the above representations are
contractually binding, and are not mere recitals, and that should I
or any of my successors assert any claim in contravention of this
agreement, I or my successors shall be liable for the expenses
(including legal fees) incurred by Performance Multisports or any
other parties in defending, unless the other party or parties are
finally adjusted liable on such claims for willful or wanton
negligence. This agreement may not be modified orally, and a waiver
of any provision shall not be construed as a modification of or as a
consent to any other provision herein or as a consent to any
subsequent waiver of modification. |
| In the
event of an accident, rescue and medical treatment may not be
immediately available. Performance Multisports seeks safety, but may
be unaware of a participant's fitness or abilities. I specifically
acknowledge that decisions made by Performance Multisports and
participants are often made in wilderness/remote/dangerous settings
and are made based on often imprecise subjective perceptions that
are subject to errors in judgment and cannot and should not be
associated with fault at a later point in time. |
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addition, I agree to abide by the rules and conditions laid down for
the event and to follow instructions issued by race officials. I
understand that circumstances beyond the control of the race
director may cause the event to be modified, postponed or relocated.
I accept that the organizers reserve the right to refuse entry from
persons considered to have insufficient experience or disqualify
those who fail to follow the rules and conditions; ignorance is no
excuse. |
| This
Agreement is given by the undersigned Applicant for the benefit of
Performance Multisports, and its respective divisions and
associations, employees, agents, members, volunteer staff, sponsors,
promoters and affiliates (collectively "Releasees"). I acknowledge
that any form of racing is inherently dangerous. I participate in
this race or activity at my own risk. Performance Multisports has
been formed to advance the sports of running and other racing, the
efforts of which directly benefit me. In consideration of and as a
condition of my participation in this event by Performance
Multisports, I individually and on behalf of my heirs, executors,
administrators, legal representatives, successors and assigns,
release and forever discharge, hold harmless, indemnify, including
as to attorney fees, and promise not to sue Releasees on, from or
against, and waive, any claims, damages, expenses or demands arising
directly or indirectly from or attributable in any way to the
negligence, action or failure to act of any Releasees in connection
with the sponsorship, organization or execution of any race or
sporting event, including travel to and from such event, in which I
may participate as a racer, rider, team member, spectator, volunteer
or in any other manner. Every term and provision in this agreement
is intended to be severable. If any one or more of them is found to
be unenforceable or invalid, that shall not affect the other terms
and provisions, which shall remain binding and enforceable. |
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I have had sufficient opportunity to
read this entire document. I have carefully read and understood it,
and I voluntarily agree to be bound by its terms. I currently have
no known physical or mental condition that would impair my
capability and am fit to fully participate in this athletic event. I
agree that my name, voice or picture may be used by Performance
Multisports and race sponsors for promotional purposes. I affirm
that the details written about me on this entry form are true.
Participation in this event shall constitute full acceptance of the
terms of this Waiver & Release.
PRINTED NAME OF APPLICANT
__________________________________________
SIGNATURE of applicant (in ink) X
________________________________________________________
Dated: __________
FOR MINORS: PARENT OR GUARDIAN MUST
COMPLETE THE FOLLOWING
I, as parent or guardian of the Applicant,
represent to the Releases that the facts herein concerning my child
or ward are true. I give my permission for my child or ward to enter
any race or event presented by Performance Multisports or its staff
or by volunteers during the period of event, and further agree,
individually and on behalf of my child or ward, to the terms of the
above agreement.
PRINTED NAME OF PARENT OR GUARDIAN
__________________________________________
Signature of Parent or Guardian X_____________________________________________________
Dated: __________ |
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Print bring this Waiver form to Team Check-in -- TEAM NAME
____________________________
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Mail completed application and fee (Check or Money Order payable
to Performance Multisports) to the address below:
Performance Multisports
Jakson Badenhoop, Director
365 Charlemagne Circle
Ponte Vedra Beach, Florida 32082
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Amount Paid:
$__________ |
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