Race2CityHall Committee is pleased to announce Jeff Hannan will be the Merchandise Coordinator for the Saturday, May 30, 2015 Benefit. We are also working on the event logo and 100% cotton black t-shirts and commemorative event posters benefiting the Athens Music History Foundation are coming soon. Sign up for Race2CityHall today! Make a copy of this form, sign and send private message to Michael Collins for mailing address. https://facebook/events/1382650592037994/ Race2CityHall - Saturday, May 30, 2015 - Participant Application I : Notice of Risk - Disclaimer of Liability - Waiver of Claims 1 : Activities associated with the Race2CityHall may involve substantial risk of injury associated with participation in the event. Potential accidents include broken bones, sprains, bruises, cuts, abrasions, concussion, heart attack and heat exhaustion. Check 2A or 2B : 2A : I have no serious health issues or problems that would preclude me from participating in Race2CityHall or that present an abnormal, unusual or unreasonable risk of, or susceptibility to, injury. Initials _______ Date _________ 2B : I have a disability which I have disclosed to the Race2CityHall organizers and I have not requested any reasonable modifications from the Race2CityHall organizers in policies, practices or procedures. Initials _______ Date _________ II : Acknowledgment and Assumption of Risk I have read the above notice carefully and acknowledge receipt of a copy thereof. I hereby assume all risks of damages or injury, including death, that I may sustain while participating in the Race2CityHall. Name __________________________________________ Date _______________ Signature ____________________________________________________________ Signature of Parent or Guardian (If Participant under 18) _____________________________________________________________________ Witness Signature _____________________________________________________
Posted on: Mon, 12 Jan 2015 19:26:08 +0000
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