United Community Change

Membership*

United Community Change 5K Freedom Run /Walk Celebration $20.00 - $35.00

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Waiver Agreement*

I agree to the United Community Change Member Waiver

1. Release and Waiver. I, the volunteer, hereby release and forever discharge and hold harmless United Community Change and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from Volunteer’s activities with United Community Chang. I understand that this Release discharges United Community Change from any liability or claim that I may have against United Community Change with respect to any bodily injury, personal injury, illness, death, or property damage that may result from Volunteer’s activities with United Community Change, whether caused by the negligence of United Community Change or its officers, directors, employees, or others acting on its behalf, except that this paragraph shall not excuse intentional harm or gross negligence. I also understand that United Community Change does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness. I agree that this Release is effective immediately and that this release is complete and forever. 2. Assumption of Risk. I hereby expressly and specifically assume all risk of injury, illness, death, or property damage resulting from my activities as a volunteer while working for United Community Change. I understand that the activities may include work that may be hazardous to the Volunteer, including, but not limited to, engaging with United Community Change participants, participating in maintenance and/or repair projects, and cleaning. While United Community Change takes all steps it can to maintain safety, I agree that I am not relying on United Community Change to do so. I understand the risks involved and accept all of the risks. 3. Medical Release. I hereby release and forever discharge United Community Change from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer’s activities with United Community Change. I hereby give permission for emergency medical treatment to be administered as deemed appropriate. 4. Media Release. I, the undersigned individual, understand that while working for or participating as a volunteer for United Community Change. I may be videotaped, photographed, or interviewed by United Community Change staff or media professionals. I hereby grant and convey to United Community Change all rights, title, and interest in any and all photographic images and video or audio recordings made by United Community Change during the Volunteer’s activities with United Community Change 5. Other. I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Missouri and that this Release shall be governed by and interpreted in accordance with the laws of the State of Missouri. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release, which shall continue to be enforceable. IN WITNESS WHEREOF, Volunteer has executed this Release as of the day and year first above written.

I agree to the Race Entry Waiver

I, the undersigned member (and my parent or guardian if I am younger than 18 years of age), intending to be legally bound, do hereby forever release and waive any and all rights, claims, and actions for damages that we, our heirs, executors, administrators, and assigns may have, or that may hereafter accrue against any and all persons, organizations, and other entities associated with the organization, including, but not limited to Race Entry, sponsors, affiliates, volunteers, United Community Change Management, arising out of or in connection with my involvement before, during, or after the association membership.

I verify that I am physically fit and sufficiently capable to participate in this membership and I assume the risks involved in this active membership. I further attest that I will be mindful of risks related to membership, and hold said sponsors and organizers blameless in any harm that may happen.

I consent to the collection and use of my Personal Information as contained in the Privacy Policy. I also give my permission for the free use of my name and/or pictures in telecasts, broadcasts, newspapers, posters, advertising, etc.

I also acknowledge understanding that the charge to my card will show up as Race Entry. I acknowledge that the online processing fees and charitable donations are non-refundable. I also acknowledge that any charitable donations will have 4.97% withheld from the donation to pay credit card and administrative costs.

Race Entry shall not be liable to you for any direct, indirect, special, incidental, consequential or exemplary damages including, but not limited to, loss of profits, goodwill, use, data or other intangible loses. Race Entry does not guarantee the completeness or accuracy of any information contained in, or provided in conjunction with the http://www.raceentry.com website. Race Entry is not responsible for any omissions or inaccuracies, or for the results obtained from this information.

Race Entry facilitates registration for various events, some of which allow memberships under the age of thirteen (13). We require a submission of birth date for all membership entries. For children under the age of thirteen (13), parental or guardian consent is required.

You agree that the statutes and laws of the State of Utah, USA, will apply to all matters relating to this Agreement and Waiver. You irrevocably consent that exclusive jurisdiction for any dispute with Race Entry relating to this Agreement and Waiver resides in the courts of Utah, and you further agree and expressly consent to the exercise of personal jurisdiction in the courts of Utah in conjunction with any such dispute including any claim involving Race Entry.

Waiver Initials*