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By checking the "I Agree" box below and clicking Submit, I understand that I am digitally signing this form and consenting to this WAIVER and each of its terms, for all participants ("Family") listed above. If the participant is under 18, I certify that I am the legal parent or guardian of the participant. If the participant is an adult, I certify that they are a member of my family and I have their authorization to consent to this waiver on their behalf.
WAIVER: In consideration of my, and/or my child’s/dependent’s participation in the 2022 STOP FOR NIKHIL Run/Walk/Bike, to be held starting Sunday, September 18, 2022 (“Event”) on behalf of myself, my child/dependent, all heirs and all assigns, I release and hold harmless The Nikhil Badlani Foundation, Inc., West Orange Board of Education and/or any other sponsors, organizers and volunteers and their affiliated entites, agents, members, employees, officers, trustees, assigns, successors, and heirs from any and all liability, loss, including any injury/death to any person; any injury, death, or illness caused by COVID-19 or any other virus, disease or illness; all damages, expenses, costs of every nature, and any cause(s) of action (including negligence) arising from and in connection with my and/or my child’s/dependent’s participation in this Event. If I and/or my child/dependent need emergency medical treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I and/or my child/dependent are voluntarily participating in this Event, and I acknowledge and willingly assume the risk of any possible injury, death or damage my and/ or my child’s/dependent’s participation may cause. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, and any other record of this event for legitimate purposes of the Nikhil Badlani Foundation, including promotional materials.
Please Type Parent/Guardian Name Inside Box below