By submitting this form you agree to the liability release below
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In signing this agreement for myself or for the named participant (if under the age of 18), I know that those participating in the Southeastern Med's Fitness 5K ("SMF5K") will be exposed to the risks of serious bodily injury, sickness, or death due to circumstances inherent in this event, including the negligent acts or omissions of others.  I understand and am aware that there are a variety of specific risks and dangers inherent in a voluntary walking and running event such as SMF5K, including, without limitation, falls; collisions with other walkers, runners, motor vehicles, animals, or stationary objects; adverse weather conditions and those caused by conditions of the road.  In exchange for being permitted to participate, I agree that I am voluntarily participating in the Event and using Event facilities or premises and assume all risk of injury, illness, damage or loss to me or my property that might result, including without limitation, any loss or theft of personal property.

In acknowledgment that I (or the participant for whom I sign, if under the age of 18) am physically capable and sufficiently trained to complete this event.  I am aware that medical support will be provided by volunteer and other personnel who may be called upon to provide assistance, including first aid during this event.  I consent and authorize any such personnel to assist me (or the participant for whom I sign, if under the age of 18) or perform such assistance or provide any medical treatment, in the opinion of such person, which may be necessary and appropriate.  I understand further that any such medical or other services provided is not an admission of responsibility to provide any such services and is not a waiver by any said parties' rights under this agreement.

Having read this waiver and knowing these facts and in consideration of SMF5K's acceptance of my application for participation in SMF5K, I, for myself and anyone entitled to act on my behalf, do agree to release, hold harmless, and discharge Southeastern Ohio Regional Medical Center, all SMF5K sponsors, representatives (including event volunteers), any involved municipalities or other organizations and the boards, trustees, officers, employees of any of them, from any and all claims or liabilities of any kind arising out of my participation in SMF5K, even though that liability may arise out of negligence, recklessness, or carelessness on the part of the persons or entities named in this waiver.  I further agree that, if in breach of this agreement, I institute such proceeding, I am responsible for all costs and attorneys' fees of any person or entity against whom I institute such proceedings.

 I also grant permission to SMF5K and its sponsors to use any photographs, motion pictures, recordings or any other record of my participation in SMF5K for legitimate purposes.

HAVING READ AND UNDERSTOOD THIS AGREEMENT, I VOLUNTARILY AND KNOWINGLY SIGN IT. SUBMITTING ONLINE FORM SERVES AS OFFICIAL SIGNATURE.

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