Please complete the entry blank, read the following statement, and sign below: In consideration of your accepting this entry, I, the undersigned, intending to be legally bound, hereby for myself, my heirs, executors and administrators, hereby voluntarily waive, release and hold harmless LONG ISLAND 2 DAY WALK TO FIGHT BREAST CANCER, THE TOWN OF BROOKHAVEN, SUFFOLK COUNTY AND SUFFOLK COUNTY PARKS, USATF and all event sponsors, and the agents, employees, successors and assigns of all of the preceding, from any and all liabilities, claims, demands, and causes of action whatsoever arising directly or indirectly from my participation in this event, even if such liabilities, claims, demands and causes of action arise in whole or in part out of the negligence of any of the above organizations or individuals. I attest and verify that I am physically fit and have sufficiently trained for the completion of this event, and that physical condition has been verified by a licensed Medical Doctor. If signed by a parent, the parent agrees to release and hold the above-named organizations and individuals harmless of any claims and rights which might otherwise have been asserted on behalf of the applicant. Further, I hereby grant permission to any and all of the foregoing organizations and individuals to use photographs, videotapes, motion pictures, recordings, and any other record of this event for any purpose whatsoever.
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