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Cleanup
   Saturday, March 23, 2013 (09:30 AM - 11:30 PM)

* Required fields

* First Name:
* Last Name:
* Address:
* City:
* State:
or * Province:
* Zip/Postal Code:
* Country:
* Gender Female Male
* Date of Birth:  
* Email :
* Home Phone:
Work Phone:
*T-shirt Size:
*What is your affiliation?:
*Cell Phone Number:
Comment
(eg: who you'd like to work with,
or, list second volunteer choice):
PLEASE READ AND AGREE TO WAIVER
By indicating your acceptance, you understand, agree, warrant and covenant as follows:

In consideration of being permitted to work for, officiate, observe, volunteer, compete or participate in any way in The Great Race of Agoura Hills (hereinafter referred to as "the Event"), I hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all rights and claims for damages I may have against, and covenant not to sue, the City of Agoura Hills, County of Los Angeles, County of Ventura, State of California, Las Virgenes Unified School District, Oak Park Unified School District, Los Angeles County Sheriffs Department, Santa Monica Mountains National Recreation Area, National Park Service, Agoura Hills Community Emergency Response Team, Dole Food Company, Inc., USA Track and Field, Los Angeles Sports and Fitness LLC, Endurance Events LLC, The Great Race of Agoura, Inc., all sponsors, all volunteers and/or any other individual associated with the above (hereinafter referred to as "the Releasees") for any and all injuries or damages I/my child may suffer as a result of I/my child competing in, observing or participating any way in The Event, including travel to and from event.

I/my child hereby agree to indemnify and save and hold harmless the Releasees and each of them from any loss, liability, damage or cost they may incur arising out of or related to the event whether caused by the negligence of the Releasees or otherwise.

I hereby assume full responsibility for any risk of bodily injury, death or property damage arising out of or relating to the event whether caused by the negligence of the Releasees or otherwise.

I hereby agree that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence by the Releasees, including negligent rescue operations, and is intended to be as broad and inclusive as is permitted by the laws of the State of California and that if any portion of thereof is held invalid, it is agreed that the balance shall notwithstanding continue in full force and effect.

I will additionally permit the use of my/my child's name and/or likeness relating to my/my child's participation in The Event for any purposes whatsoever and I waive all right to any future compensation to which I may otherwise be entitled as a result of the use of my/my child's name or likeness. I further attest and verify that I/my child am/is physically fit and sufficiently trained for the competition of or participation in The Event and my/my child's physical condition has been verified by a licensed medical doctor.

I certify that all information provided in this form is true and complete and that I am (or that my son/daughter is) the person who will participate in The Event. I have read the information provided for The Event and this release and waiver of liability and certify my/my child's compliance by signature below or if via electronic registration by clicking the button next to "I agree" below.

IF PARTICIPANT IS UNDER AGE 18: This is to certify that my son/daughter has my permission to compete or participate in The Great Race of Agoura Hills, is in good physical condition, and that race officials have my permission to authorize emergency treatment if necessary.
 

 
INFO FOR PARENT/GUARDIAN COMPLETING THIS REGISTRATION
Registration for minors must be completed by a Parent or Legal Guardian. If your age on race day is less than 18 years old, please fill in the Parent/Guardian Contact Information below. Providing such information and continuing this process indicates that this registration was completed by the person listed below.
Parent/Guardian Name:
Contact Phone:
Contact Relationship:
 
*Agree to waiver: I agree I do not agree