Spring 2012 Program Registration

I know participating in any event is a potentially hazardous activity. I am in adequate physical condition to participate. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with participating in this event including, but not limited to: illness, falls, contact with other participants, the effects of the weather, including cold, snow and/or ice, 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 for myself and anyone entitled to act on my behalf, waive and release Girls on the Run of the Rockies, Girls on the Run International, BKB Ltd., its sponsors, its directors, officers and chairpersons and staff and volunteers from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons covered by waiver and release. I understand and agree that the entry fee is non-refundable and non-transferable. I grant permission to all of the foregoing to use any photograph, recording, (sound or video) or any other record of this event for any legitimate purpose without charge.

In consideration of acceptance of entry in the 2012 Women’s Distance Festival, I, intending to be legally bound for myself, my heirs, executors, and administrators, do hereby release and discharge Pikes Peak Road Runners, Colorado Springs Parks, Recreation and Cultural Services, and any other support of the 12WDF, from any and all liability arising from illness, injuries and damages I may suffer, including those which may be attributed to weather conditions, high altitude and a course that is composed of or has loose rocks or sand, as a result of my participation in this event. I attest and verify that I will participate in this event as a foot race entrant, that I am physically fit and that I have sufficiently trained for the event. I have read all entry information provided and certify my compliance by my signature below. I also understand that my entry fees are non-refundable. I or my Parent/guardian also authorizes and consents to the use of participant's name and/or picture in television, newsprint, advertisement or other media. Lack of signature on my part (or my legal guardian's) does not nullify this entry form.

As the parent or legal guardian of the Particpant, 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 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 each of Girls on the Run of the Rockies and Girls on the Run International, their owners, directors, officers, contributors, sponsors, employees, contractors, agents and assigns against and from any causes of action, claims, demands, damages, costs, loss of services, expenses, compensation, all 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. In addition, I hereby authorize Girls on the Run of the Rockies, 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 of the Rockies for all costs and expenses it may incur related to such treatment. I hereby grant to Girls on the Run the absolute and irrevocable right and permission, in respect of the photographs and videos that have been or will be taken of the Participant or 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 or hereafter known, and for any purpose whatsoever; and to use my name in connection therewith. I hereby release and discharge Girls on the Run from any and all claims and demands arising out of or in connection with the use of the photographs and videos, including without limitation any and all claims for libel or invasion of privacy. I understand Participant may complete a confidential pre and post survey at the beginning and conclusion of the program. The survey measures student attitudes toward school, family, self and peers. The purpose of the survey is to measure any group attitudinal changes that occur because of participation in the Girls on the Run program. This survey was developed especially for Girls on the Run by Rita DeBate, PhD, University of South Florida. Registration and test information is shared with Girls on the Run International. I understand Participant may receive antiperspirant/deodorant as gift from Secret®, a national sponsor of Girls on The Run. Secret proudly supports the Girls on The Run program in helping prepare girls for a lifetime of self-respect and healthy living. 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 portion thereof is held invalid, it is agreed that the balance 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 Girls on the Run. 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. I have fully read the above permissions and releases, 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. 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.