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405 Run Club

Run Check-In Survey

This is a brief attendance survey for the 405 Run Club events! This survey should only be completed while at the run.
1.First Name(Required.)
2.Last Name(Required.)
3.Email(Required.)
4.Phone Number
5.Age (numeric answer ONLY)(Required.)
6.IF you are participating with child(ren) please enter full name(s) below:
7.405 Run Club Liability Waiver and Release

I hereby acknowledge and agree to the following terms and conditions in consideration of my participation in the Event hosted by the 405 Run Club. I fully understand the risk involved, and that it is possible to sustain serious injury, while engaging or participating in this 405 Run Club event. I expressly, assume all risk of injury arising out of my use or participation, however caused, or arising, and accepting personal responsibility for any losses or damages following such injury. I agreed to identify, hold harmless, release and discharge 405 Run Club, their officers, directors, employees, agents, volunteers, and any other affiliated entities (collectively "the Released Parties") from any and all liability for any and all loss, damage, injury, claims, or demands relating to arising from my participation. I further release and discharge the Released Parties from any in all claims or causes of action I may have for damages for personal or bodily injury (whether myself or my child), illness, disability, death, loss, or damage to person or property, whether arising from the negligence of the Released Parties or otherwise, to the fullest extent permitted by law; I further certify that the attendee (whether myself or my child) is in good physical condition and able to safely participate in this 405 Run Club event; and I agreed to defend and indemnify the Released Parties from and against any liability arising out of any claim of any invalidity of this submission. Lastly, I authorize 405 Run Club and its representatives to provide or arrange for medical treatment and transportation as may be deemed appropriate and necessary in their discretion, in the event of injury, accident, or illness during my participation. I further agree to be responsible for any costs associated with such treatment and medical transportation.(Required.)
8.405 Run Club Disclaimer

I hereby grant to the 405 Run Club the absolute right and permission to copyright, use, reproduce and publish, for art, advertising, trade or any other lawful purpose whatsoever, any photographic portraits or pictures, videotapes, recordings or any other graphic reproductions of me, or in conjunction with my own name, in connection with the program above, without notice to me and without compensation. I consent to the use of my name, likeness, voice and biographical material about me in connection with the program above on publicity about such program. I understand and agree that this is a complete release and discharge of all claims and rights I may have against 405 Run Club. I understand that this release shall be binding upon my heirs, executors, executors, successors, and assigns. I understand that I shall have no right of approval regarding this grant of rights. I waive any right that I may have to inspect or approve the finished product or the advertising or other copy that may be used. I hereby release and discharge 405 Run Club and all persons acting under its permission or authority from any liability by virtue of any blurring, distortion, alteration, optical illusion or use in composite form, that may occur or be produced in the taking of the pictures or the finished product. I have read this release prior to its execution, and I am fully familiar with, understand and consent to its contents. By attending the Event, I agree to release and hold harmless 405 Run Club from and against any claim or cause of action arising out of my participation, including, but not limited to personal injury, death or damage to persons or loss or damage to property.(Required.)
9.I promise that everything I said here is true, and I understand that the Released Parties are relying on this information to let me participate in the Event. I have read this statement, and I agree to it willingly. I understand that I take on the risks involved and will not hold the Released Parties responsible for anything related to my participation in the Event.(Required.)