WAIVER WILL NEED TO BE SIGNED AT THE CHECK IN DESK DATE OF RACE
PARTICIPANT WAIVER & RELEASE
EVENT: Race to Adopt – Race to Foster
LOCATION: Forest City Dunbar Elementary School
DATE: November 7, 2026
I/We understand that participation in this event may involve certain risks. By signing below, I/we voluntarily agree to participate and assume responsibility for any risks associated with participation. I/We release and hold harmless Rutherford County Department of Social Services, Rutherford County, its employees, representatives, volunteers, and agents from claims arising from participation in this event, except as otherwise provided by law.
Participants
Participant Name: ____________________________________ Adult / Child (circle one) Age: ______
Participant Name: ____________________________________ Adult / Child (circle one) Age: ______
Participant Name: ____________________________________ Adult / Child (circle one) Age: ______
Participant Name: ____________________________________ Adult / Child (circle one) Age: ______
Participant Name: ____________________________________ Adult / Child (circle one) Age: ______
Emergency Contact
Emergency Contact Name: ______________________________________________________
Emergency Phone Number: _____________________________________________________
Acknowledgment & Signature
By signing below, I acknowledge that I have read and understand this Participant Waiver & Release. If signing on behalf of a minor participant, I certify that I am the minor's parent or legal guardian and have authority to sign on their behalf.
Signature of Participant/Parent/Legal Guardian:
Printed Name: __________________________________________
Date: __________________________