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Course Team 170 HIDE diet
   Saturday, April 27, 2013 (07:00 AM - 09:15 AM)

* 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:
*Mobile Phone Number (used for official marathon communication only):
Having a car to block drive/alley is helpful for the 5K. Are you willing and able to use your car at this position?:
*Are you a Christie Clinic employee?:
*Have you been an Illinois Marathon Course Team Intersection volunteer in prior years?:
Comment
(eg: who you'd like to work with,
or, list second volunteer choice):
PLEASE READ AND AGREE TO WAIVER
I am over the age of eighteen and I wish to volunteer for the Christie Clinic Illinois Marathon. I understand that the nature of volunteer activities that I may perform in my capacity as a volunteer may involve physical activity, contact with unidentified and/or unfamiliar persons, or other potential risk of bodily injury or damage to property. Knowing this and in consideration of being allowed to volunteer, I HEREBY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR ANY PERSONAL INJURY AND/OR PROPERTY DAMAGE THAT I SUSTAIN OR CAUSE DURING MY PARTICIPATION AS A VOLUNTEER. IN ADDITION, I HEREBY RELEASE, HOLD HARMLESS AND COVENANT NOT TO FILE SUIT AGAINST C-U MARATHON LLC D/B/A CHRISTIE CLINIC ILLINOIS MARATHON and/or their successors or assigns.

I acknowledge that I am volunteering to perform services for C-U MARATHON LLC D/B/A CHRISTIE CLINIC ILLINOIS MARATHON with no expectation of pay or remuneration of any kind. I understand that I will not be employed by or be an employee of C-U MARATHON LLC D/B/A CHRISTIE CLINIC ILLINOIS MARATHON. Because I will not be an employee, I understand that I will not be covered by either state unemployment or state workers??? compensation laws. I further acknowledge that my volunteer services will not entitle me to any employee benefits provided by C-U MARATHON LLC D/B/A CHRISTIE CLINIC ILLINOIS MARATHON to its employees.

I may decide to terminate my volunteer services at any time and for any reason, with or without notice.

I further grant C-U Marathon LLC d/b/a Christie Clinic Illinois Marathon permission to use my likeness in photograph(s) and video for any purpose in any publication, website, and in any and all other media whether now known or hereafter existing in perpetuity. I AGREE THAT I WILL MAKE NO MONETARY CLAIM OR OTHER CLAIM FOR THE USE OF THE PHOTOGRAPH(S) AND VIDEO.
 

 
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