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Burrito Biathlon

Ixonia, WI 53036

Registrant #1

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$30.00 + $4.10 SignUp Fee

$30.00 + $4.10 SignUp Fee

Kid's Run
Open to ages 1 - 10.

$0.00

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Waiver

ACKNOWLEDGEMENTS AND WARNINGS 

By indicating your acceptance, you understand, agree, warrant and covenant as follows:

1. I acknowledge that the Event is a risky activity. 

3. I agree not to participate unless I am medically able.  In registering for the race, programs/activities, I recognize that there is an inherent risk of injury in choosing to participate in the recreational activities/programs. I am solely responsible for determining if I am mentally able, physically fit and/or skilled for the Event. If I am pregnant or disabled in any way or recently suffered an illness, injury or impairment, I will consult a physician before undertaking any physical activity associated with the Event. 

4. I agree to not consume alcohol prior to the Event or ingest any medicines or substances that will inhibit my mental or physical ability to safely and effectively participate in the Event.

5. I acknowledge and agree that participation in the Event requires extreme feats of a person’s physical and mental limits and carries with it the potential for death, serious injury or property loss.

6. I acknowledge that I need to maintain my own medical, disability and life insurance sufficient in determination to cover any expenses and damages that I, or my family, may incur, including loss of income, arising from my injury, disability or death.


7. I agree to abide by any decision of a race official/organizer/director relative to my ability to safely complete the race.


8. I agree to obey all civil and criminal laws at all times. 


9. I assume all risks associated with competing in the Event, including but not limited to falls, contact with other participants, negligent or wanton acts of other participants, completing all obstacles, defects or condition of premises, the effects of the weather, including high heat and/or humidity, cold weather, rainy and wet weather, tornados or any other adverse weather conditions, and all such risks being known and appreciated by me. 


10. I agree that Silver Circle Sports Events, LLC, Jefferson County, Town of Ixonia, or Von Loppys is not responsible for any personal items or property that are lost or stolen in the gear check area.


11. I consent to emergency medical care and transportation in order to obtain treatment in the event of injury to me as medical professionals may deem appropriate. 


12. I acknowledge and will abide by the rule that no wheeled baby conveyances or other wheeled devices of conveyance, are permitted in the race.


13.  I acknowledge no animals are permitted in the race.


14. I grant permission to Silver Circle Sports Events, LLC, it's affiliates, sponsors, and assigns to use any photographs, motion pictures, recordings or any other record of this event for any purpose including but not limited to promoting, advertising and marketing purposes. Any and all photographs, motion pictures, recordings or other records of the event are the sole property of Silver Circle Sports Events, LLC.


15. I acknowledge that all entries are final with no refunds.


16.  I acknowledge that the official race directors reserve the right in any event of emergency, severe weather, local or national disaster to cancel the race and in the event of cancellation or change there is no refund of entry fees.


17. I acknowledge that participants are expected to exhibit appropriate behavior at all times, including obeying all laws. This includes respect for all people, equipment, and facilities, and cooperative, positive participation. The Event may dismiss, without refund, anyone whose behavior endangers safety or negatively endangers safety or negatively affects a race, a person, a facility, or property of any type or kind. I also agree to indemnify Silver Circle Sports Events, LLC, Waukesha County its affiliates and assigns, from any and all third party claims caused in whole or in party by my actions.


18. I am at least 12 years old.  If I am under the age of 18, my parent(s)/legal guardian(s) consent(s) to my participation in the Wisconsin Trail Assail and acknowledge the same by signing below.

 

____________________________________________ (signature)   _______________ (date)

 

____________________________________________ (print name)

 

Parental/Legal Guardian Signatures:

 

(1)  ___________________________________________ (signature)   _______________ (date)

 

____________________________________________ (print name)

 

 

(2) ____________________________________________ (signature)   _______________ (date)

 

____________________________________________ (print name)

 

 


Waiver and Release of all claims, assumption of risk and indemnity agreement


this document must be carefully read and signed by each participant.  in consideration of being permitted to participate in the Event (the "Event"), I, for myself, and for my heirs, successors, and assigns, acknowledge, agree and represent that I am physically, mentally, and medically fit and sufficient skilled to compete in the Event and further warrant that my participation in the Event constitutes an acknowledgement that I have determined that the Event is reasonably safe and that I am capable of safely competing in the Event and further agree and warrant that, if at any time I feel anything about the Event is unsafe, I will refuse to participate further in the Event and will immediately advise the officials of any unsafe situation.

 

            1.         I hereby release, waive, discharge and covenant not to sue Silver Circle Sports Events, LLC, Waukesha County its officials, agents, volunteers, sponsors, and employees (hereinafter collectively referred to as Silver Circle Sports Events, LLC or Wisconsin Trail Assail), from all liability to me for any and all loss or damage, and any claims for injuries, illnesses, damages, expenses, or loss that I may have or which may accrue to me arising out of, connected with, or in any way associated with the race, program, activities of the Event caused by the negligence Silver Circle Sports Events, LLC.  This agreement extends to negligent rescue, negligent transportation, and/or negligent medical care in the event of an emergency.

 

            2.         I hereby agree to indemnify and save and hold harmless Silver Circle Sports Events, LLC from any loss, liability, damage or cost it may incur due to my presence or participation in the Event and caused by my negligence or the negligence of Silver Circle Sports Events, LLC.

 

            3.         I hereby assume full responsibility for and risk of bodily injury or death due to the negligence of Silver Circle Sports Events, LLC while participating in the Event.  I also assume the risk of negligent rescue, transportation, and/or medical care in the event of an emergency.

 

            4.         I acknowledge that and agree that participating in the Event is very dangerous and involves the risk of serious injury or death.

 

            5.         I acknowledge that this waiver of liability is the result of a bargain reached between me and the Released Parties for which adequate consideration has been exchanged.  I knowingly waive the right to bargain for different waiver of liability terms because if this waiver were not as broad as it is, Silver Circle Sports Events, LLC may not offer the opportunity to participate in the Event and/or participation would cost significantly more, or even be cost prohibitive.

 

            6.         When registering online, my online signature shall substitute for and have the same legal effect as an original form signature, I have read and fully understand the waiver and release of all claims, assumption of risk and indemnity agreement and I sign the same on my own free act and deed. The undersigned further agrees that this Agreement is intended to be as broad and inclusive as permitted by law in the State of Wisconsin, and that if any portion hereof is found invalid, it is agreed that the balance will, notwithstanding, continue in full force and
effect.

 

Signature_____________________________________ Date _______________

 

Print Name ___________________________________ 


Waiver and Release of all claims, assumption of risk and indemnity agreement


this document must be carefully read and signed by each participant.  in consideration of being permitted to participate in the Event (the "Event"), I, for myself, and for my heirs, successors, and assigns, acknowledge, agree and represent that I am physically, mentally, and medically fit and sufficient skilled to compete in the Event and further warrant that my participation in the Event constitutes an acknowledgement that I have determined that the Event is reasonably safe and that I am capable of safely competing in the Event and further agree and warrant that, if at any time I feel anything about the Event is unsafe, I will refuse to participate further in the Event and will immediately advise the officials of any unsafe situation.

 

            1.         I hereby release, waive, discharge and covenant not to sue Silver Circle Sports Events, LLC, Waukesha County its officials, agents, volunteers, sponsors, and employees (hereinafter collectively referred to as Silver Circle Sports Events, LLC or Wisconsin Trail Assail), from all liability to me for any and all loss or damage, and any claims for injuries, illnesses, damages, expenses, or loss that I may have or which may accrue to me arising out of, connected with, or in any way associated with the race, program, activities of the Event caused by the negligence Silver Circle Sports Events, LLC.  This agreement extends to negligent rescue, negligent transportation, and/or negligent medical care in the event of an emergency.

 

            2.         I hereby agree to indemnify and save and hold harmless Silver Circle Sports Events, LLC from any loss, liability, damage or cost it may incur due to my presence or participation in the Event and caused by my negligence or the negligence of Silver Circle Sports Events, LLC.

 

            3.         I hereby assume full responsibility for and risk of bodily injury or death due to the negligence of Silver Circle Sports Events, LLC while participating in the Event.  I also assume the risk of negligent rescue, transportation, and/or medical care in the event of an emergency.

 

            4.         I acknowledge that and agree that participating in the Event is very dangerous and involves the risk of serious injury or death.

 

            5.         I acknowledge that this waiver of liability is the result of a bargain reached between me and the Released Parties for which adequate consideration has been exchanged.  I knowingly waive the right to bargain for different waiver of liability terms because if this waiver were not as broad as it is, Silver Circle Sports Events, LLC may not offer the opportunity to participate in the Event and/or participation would cost significantly more, or even be cost prohibitive.

 

            6.         When registering online, my online signature shall substitute for and have the same legal effect as an original form signature, I have read and fully understand the waiver and release of all claims, assumption of risk and indemnity agreement and I sign the same on my own free act and deed. The undersigned further agrees that this Agreement is intended to be as broad and inclusive as permitted by law in the State of Wisconsin, and that if any portion hereof is found invalid, it is agreed that the balance will, notwithstanding, continue in full force and
effect.

 

Signature_____________________________________ Date _______________

 

Print Name ___________________________________ 

 

ACKNOWLEDGEMENT BY PARENT OR LEGAL GUARDIAN

As parent(s) or  legal guardian(s) of the participant named above, I acknowledge that I am aware of the participation of our son/daughter in the Wisconsin Trail Assail.  I further acknowledge and accept the terms of the liability Waiver and Release, Assumption of Risk and Indemnity Agreement.  I have read the liability waiver and release, of all claims, assumption of risk and indemnity Agreement and fully understand its terms, understand that my/our child and I/we have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

 

Print Full Name of Parent/Legal Guardian                                                                                              

 

Signature of Parent/Legal Guardian: ______________________________Date:                               

 

Print Full Name of Parent/Legal Guardian:                                                               

 

Signature of Parent/Legal Guardian:                                                           ­­­­­­­­     Date: _______________




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