St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
St Kateri’s Run with the Son for Haiti Runners/Walkers Agreement Waiver, Release & Acknowledgment
All runners and walkers are required to sign the waivers below. All registrations for participants under 18 must be signed by parent or guardian. Registrations that are not signed will not be processed.
I know that running a road race is a potentially hazardous activity. I should not enter a run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risk associated with running this event, including, but not limited to falls, contact with other participants, the effects of weather, including, high heat 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 the Running Man Subdivision, York County, Peninsula Track Club, St. Kateri Tekakwitha Catholic Church, 5K volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules of RRCA and USATF; it is not intended for individuals with headphones, dogs on leashes, skateboards, skates or rollerblades.
Signature of Participant _____________________________________________________ Date _________________________
Signature of Parent/Guardian if under 18 _______________________________________ Date _________________________
*********************************************************************************************************************************************************************************
Additional Waivers:
ADULT LIABILITY WAIVER (Catholic Diocese of Richmond)
Parish/School: St. Kateri Tekakwitha Catholic Church______________________ Nature of Activity:_5K Run/Walk______________________
Date: _December 2, 2023___________________________________________ Duration: _________________________________________
RELEASE OF LIABILITY (Catholic Diocese of Richmond)
The undersigned, his/her personal representatives, heirs and assigns, DO HEREBY:
1. RELEASE, DISCHARGE AND COVENANT NOT TO SUE St. Kateri Tekakwitha Catholic Church and the Catholic Diocese of Richmond for any and all claims and liability, except for those arising out of the strict liability or negligence of releasee which causes the undersigned injury, death or property damage and further agrees to hold releasee harmless and indemnify releasee from any claim, judgment or expense releasee may incur by participation in the described activity.
2. UNDERSTAND that participation in the described activity may involve danger and risk of injury. The inherent danger is understood and voluntarily assumed.
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Name (print) Signature
* For Participants Under 18. Must be signed by Parent or Guardian.
PARENTAL/GUARDIAN CONSENT FORM AND LIABILITY WAIVER (Catholic Diocese of Richmond)5k 2024 Flyer Registration with QR code.pdf
Participant’s name: ___________________________________Birth date:_________________ Sex: ___________
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor.
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Kateri Tekakwitha Catholic Church, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the event, arising from or in connection with my child attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents, and the Diocese of Richmond , coaches, chaperons, or representatives associated with the activity for reasonable attorney’s fees and expenses arising in connection therewith.
Signature of Parent/Guardian: ___________________________________________________ Date: ____________________
Name (Print) __________________________________________________________________________________________
