"5K Run/Walk For Sight"

Participant 1 Information

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Registration Information

Mandatory Waiver & Release of Liability

DISCLAIMER - Please read and sign the following waiver:
By indicating your acceptance, you understand, agree, warrant and covenant as follows: In agreement
of acceptance of this entry, I hereby waive any and all claims for myself and my heirs against
Cabell Wayne Association of the Blind; the sponsors of the 5K Run / Walk, and each of their agents,
servants, officers and employees of the host town, for injury or illness, which may directly or indirectly
result from my participation and I further agree to save and hold said parties harmless and
agree to indemnify each of said persons against all liability for any loss, costs, injury or damage to
persons or property, which may arise by virtue of the undersigned engaging in the CWAB 5K
events. I further state that I am in proper physical condition to participate in this event. Sponsors
and organizers reserve the right to postpone, cancel or modify the event due to weather conditions
or other factors beyond the control of the sponsors and organizers, which might affect the health
or safety of the participants. I also understand that pictures may be taken at the time of the event
and may be allowed to be used when needed

I agree that I am releasing the service provider (www.tristateracer.com) from liability for injuries resulting from the ordinary negligence of the provider.

By clicking the Accept Waiver button below, I agree that I have read and accept the above waiver. I also agree that I am over 18 years of age OR the parent/legal guardian of a minor under 18 years of age OR the legal guardian of an incapacitated and/or mentally challenged person.

By clicking the Accept Waiver button below, I am also agreeing that I have read and accept the
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