Walk Participation Release Form

Waiver of Liability & Disclosure Form             

I understand there is an inherent risk associated with any exercise including my voluntary participation in today’s event that may result in injury. The exercises will challenge my cardio respiratory and musculoskeletal systems associated with the aerobic, anaerobic, strength, power, agility, flexibility and breathing components of the program. I understand and am aware that the components of exercise are potentially hazardous activities and may cause injury.

I acknowledge that I have either had physical examination and/or have been given permission by my physician to participate in a walk, or that I have decided to participate in a walk voluntarily and without the approval of my physician and do hereby assume all responsibility for my participation in today’s event associated with Boro Pregnancy Counseling Center (BPCC).

I certify that I am physically well and suffering from no medical problems, conditions, impairments, diseases, or any other illnesses that would prevent my participation or increase my risk of injury and/or illness as a result of participating in today’s walk.

I understand that the BPCC strongly recommends that I have medical insurance for the Event.   I will bring my medical insurance card with me.  I acknowledge that I am solely responsible for procuring and maintaining all medical insurance.  I accept full responsibility for any costs incurred for medical treatment due to failure to maintain insurance. I understand that it is ultimately my responsibility to provide payment to any hospital/emergency response technicians/emergency transport company that may provide services to me as a result of injury/illness during the walk.

I, my heirs, or legal representatives, do hereby waive and release BPCC, their employees and volunteers from any and all liability and responsibility from injury, accident, illness, legal and medical fees sustained now or in the future resulting from my participation in today’s walk.

I agree that BPCC is in no way responsible for the loss or damage of my belongings while I attend today’s event.

I consent to the taking of photos and/or video of myself and my minor children by BPCC.  I grant BPCC the right to edit, use and reuse said products for promotional purposes without prior notification or financial compensation.

I acknowledge that I have read this waiver of liability form. I fully understand its terms and conditions and understand that I am giving up my right to sue BPCC, their employees, and volunteers. I acknowledge that I am signing this agreement voluntarily, and thereby intend this action to be a complete and unconditional release of liability to the greatest extent allowable by law.