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Dan Wolfe Memorial Run (Formerly Susquehanna Hometown Days 5K)

Susquehanna, PA 18847

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By selecting this box, you are indicating that you are the parent/guardian of the person you are about to register. Additionally, if the child is under the age of 13, you are consenting to the collection and use of the information about the child for the purpose of the registration as described in our privacy policy.

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In consideration of you accepting this entry, I, the participant, intending to be legally bound do hereby waive and forever release any and all right and claims for damages or injuries that I may have against the Event Director,, and all of their agents assisting with the event, sponsors and their representatives, volunteers and employees for any and all injuries to me or my personal property. This release includes all injuries and/or damages suffered by me before, during or after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.

I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able to do so and properly trained. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, traffic, and course conditions, and waive any and all claims which I might have based on any of those and other risks typical found in running a road race. I acknowledge all such risks are known and understood by me. I agree to abide by all decisions of any race official relative to my ability to safely complete the run. I certify as a material condition to my being permitted to enter this race that I am physically fit and sufficiently trained for the completion of this event and that a licensed Medical Doctor has verified my physical condition.

In the event of an illness, injury or medical emergency arising during the event I hereby authorize and give my consent to the Event Director to secure from any accredited hospital, clinic and/ or physician any treatment deemed necessary for my immediate care. I agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medications, treatment and hospitalization.

By submitting this entry, I acknowledge (or a parent or adult guardian for all children under 18 years) having read and agreed to the above release and waiver.

Further, I grant permission to all the foregoing to use my name, voice and images of myself in any photographs, motion pictures, results, publications or any other print, videographic or electronic recording of this event for legitimate purposes.

I know that running/walking a race is a potentially hazardous activity. I certify that I am physically fit have sufficiently trained and prepared for participation in the event and have not been advised otherwise by a qualified medial person. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I hereby consent to receive medial attention which may be deemed advisable in the event of an injury, accident and/or illness during this event. I understand that all evacuation and medical cost for participants and volunteers will be borne by that person or their heirs. The race organizers and sponsors are in no way liable or responsible for medial costs or emergency evacuations.

The race directors have addressed all safety issues on the pave and dirt/hard pack and loose gravel race course trails areas. I assume all risks associated with running in the event, including, but not limited to, falls, contact with other participants, volunteers, race officials, sponsors, walkers, baby strollers or "baby-joggers", in-line-skating, dogs on leashes, bicycles, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me.

Having read this waiver and knowing these facts, and in consideration of your accepting my entry, I hereby take action for myself, my heirs, executors, next of kin, administrators or anyone else who might claim on my behalf , waive and release the following Entities or Persons: The Susquehanna Community Development Association, all involved municipalities or public entities (and their respective agents and employees) the event holders, the event sponsors (and their directors, officers, volunteers, representatives and agents), event volunteers and event directors, from all claims or liability for death, personal injury, or property damage of any kind or nature whatsoever arising out of, or in the course of, my participating in this event whether same be caused by negligence or fault. This release and waiver extends to all claims of every kind orr nature whatsoever, foreseen or unforeseen, known or unknowns and I indemnify and hold harmless the entities or persons mentioned in this paragraph from any or all liabilities or claims made by any other individual or entities as a result of my actions during this event.

PARENTS OR GUARDIAN WAIVER FOR MINORS (UNDER 18-YEARS OLD) IF APPLICABLE: The undersigned parent and natural guardian or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all parties referred to above from all liability, loss, cost, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to act and release said parties on the behalf of the minor and parents or legal guardian. Minors accepted only with a parent or guardian's signature

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This is a service fee for processing your race application.

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