WAIVER OF LIABILITY AND PERMISSION TO PARTICIPATE
Program Consent, Release and Waiver: I am the parent or legal guardian of the girl named above, a minor (“Participant”). I agree that the Participant may participate in the Girls on the Run® program. The purpose of the program is to increase the Participant’s activity/fitness level and self-esteem while at the same time teaching life skills that will be beneficial to the Participant as she enters middle school/adolescence. I understand that during the program, the Participant will be involved in indoor and outdoor physical activities. Physical reactions to exercise may include heat-related illness, abnormal heartbeats and blood pressure and, in rare instances, events such as heart attacks. While Girls on the Run takes all reasonable precautions, we can make no guarantees regarding these and other risks. Recognizing the risks of the program, and in consideration for allowing the Participant to participate in the program, I hereby release, discharge and agree to hold harmless, and to indemnify the Girls on the Run of Nebraska council conducting the Girls on the Run® program for Participant and Girls on the Run International, their owners, directors, affiliates, officers, contributors, sponsors, employees, contractors, agents and assigns against and from any and all causes of action, claims, demands, damages, costs, loss of services, expenses, compensation, consequential damages and attorneys’ fees (regardless whether pursuant to the laws of any county, state or country) claimed by, through or on behalf of me or the Participant related directly or indirectly to the program (including without limitation the 5k race), and specifically including any and all claims for personal injuries sustained while participating in program activities without regard to negligence or negligent conditions.
Consent to Emergency Medical Treatment: In addition, I hereby authorize Girls on the Run, if after a reasonable attempt has been made to reach a parent, guardian or emergency contact to obtain consent, or if sound medical practice decrees that there is not time to make such an attempt, to consent to any x-ray examination, anesthetic, dental, medical or surgical diagnosis or treatment, and hospital care, to be rendered to the Participant under the general or special supervision and on the advice of any physician or surgeon who may treat the Participant, and consent to any x-ray examination, anesthetic, dental, medical or surgical diagnosis or treatment and hospital care, to be rendered to the Participant by any health care professional who may treat the Participant. I agree to pay for any such treatment and to reimburse Girls on the Run for all costs and expenses it may incur related to such treatment.
Photo Release: I hereby grant Girls on the Run®, its National Title Sponsors, its National Sponsors, and all assigns, licensees, successors in interest, legal representatives, employees, consultants, and those acting with permission or authority of the aforementioned parties, the absolute, irrevocable and unrestricted right to use photographs, video likenesses and audio recordings (including without limitation all originals, negatives, prints and transparencies or any duplicates or reproductions of the foregoing) that have been or will be taken of the Participant (collectively, “Images”), in which the Participant may be included with others, to copyright the same, in the name of Girls on the Run or otherwise; to use, re-use, publish and republish the same in whole or in part, individually or in conjunction with other photographs and videos, and in conjunction with any printed matter, in any and all media now and hereafter known, and for any purpose whatsoever; and to use my name in connection herewith. I hereby release and agree to hold harmless Girls on the Run of Nebraska, Girls on the Run International and all aforementioned entities, from any damages or liability relating to or arising from any use of or modification, alteration, distortion or other change to any of the Images and/or information gathered, unless it can be proven that such reproduction were maliciously caused, produced and published for the sole purpose of subjecting Participant to conspicuous ridicule, scandal, reproach, scorn and indignity. I hereby waive any claims I may have based on any usage of the Images, information gathered, or works derived thereof, including but not limited to claims for either invasion of privacy or libel. I represent, warrant and agree that the Participant will not disaffirm or disavow this release on the ground that the Participant was a minor on the date it is executed or any similar grounds whatsoever.
Sponsor Gifts: From time to time, Girls on the Run sponsors may provide products or offer services to participants. I understand that Participant may receive products or service offerings from sponsors of Girls on the Run, and consent to their provision and Participant’s receipt thereof.
Authorization: I expressly agree that this consent is intended to be as broad and inclusive a release of liability as permitted by applicable law and that if any provision thereof is held invalid, it is agreed that the remaining provisions shall, notwithstanding, continue in full legal force and effect. I hereby warrant and represent that I am 18 years old or older; I have carefully read this consent and agree to its terms and conditions, that before signing this agreement I had the chance to ask questions; and I am aware that by signing this consent, I assume all risks and waive and release certain substantial rights that I and Participant may have or possess against the Girls on the Run council conducting the Girls on the Run® program for Participant and Girls on the Run International. To the extent permitted by applicable law, I hereby irrevocably and unconditionally waive trial by jury in any legal action or proceeding related to this agreement.
Parent/Guardian Electronic Signature: I have fully read the above permissions, policies and releases. I understand them and I expressly agree to them. I hereby certify that there are no contraindications to the Participant’s participation in the Girls on the Run program and the 5K. I am the parent or legal guardian of the Participant, and this permission and release is binding on me and my executor, administrators and heirs.