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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 2019 STOP FOR NIKHIL Run/Walk, to be held on Sunday, September 15, 2019 ("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, USA Track & Field, Inc. its employees, directors, assigns and USA Track & Field certified officials and/or any other sponsors, organizers and volunteers and their assigns, successors and heirs from any and all liability, loss, including any injury/death to any person; damage, expense, cost of every nature, and any cause 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 that may be sustained by me and/or my child/dependent as a result of participation in this Event. Further, I grant permission to all of the forgoing to use any photographs, motion pictures, recordings, and any other record of this Event for legitimate purposes.
Please Type Parent/Guardian Name Inside Box below