SPECIAL OLYMPICS NORTHERN CALIFORNIA, INC. RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT ("AGREEMENT") FOR “POLICE IN PURSUIT” FUNDRAISING EVENT
In consideration of participating in the “Police in Pursuit” fundraising car race event to benefit Special Olympics Northern California, Inc., taking place June 26, 2020 at the Ocean Speedway in Watsonville, California and presented by local law enforcement agencies (“Event”), I represent that I understand the nature of car race events and this Event and that I am qualified, in good health, and in proper physical condition to participate in the Event. I acknowledge that if I believe at any time that Event conditions are unsafe, I will immediately discontinue participation in the Event and any related activities.
I fully understand that the Event and any related activities involve risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions or inactions, those of others participating in the Event, the conditions in which the Event takes place, or the negligence of any of the "Releasees" named below; that I, and not any of the named Releasees, shall be solely responsible for the condition and performance of the vehicle I drive in the Event and any related activities; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for any losses, costs, and damages I may incur as a result of my participation in the Event and any related activities.
I hereby release, discharge, and covenant not to sue Special Olympics Northern California, Inc., Special Olympics, Inc., each of their administrators, directors, agents, officers, volunteers, and employees, other participants, any Event sponsors, advertisers, and the owners and any lessors of premises or equipment on which the Event takes place (each considered one of the "Releasees” named herein), from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of any of the Releasees or otherwise, including negligent rescue operations; and I further agree that if, despite this Agreement, I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost which any may incur as the result of such claim.
I hereby consent to receive any medical treatment which may be deemed advisable for me in the event of injury and/or illness during the Event and any related activities. I understand that I or my health insurer (and not any of the Releasees or their insurers) will be responsible to pay for or otherwise cover any or all of the expenses in connection with any injury and/or illness that I may suffer in connection with the Event and any related activities.
In addition, I hereby authorize any of the Releasees, and/or their agents, to photograph, film, tape, or otherwise create audio and/or video recordings, still images and/or textual descriptions of me, and to use the same for any legitimate purpose, as well as to use my name and biographical information in connection therewith, without compensation or permission.
I am at least 18 years of age or older, and have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT. I understand that I have given up substantial rights by signing the Agreement and have signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law, and agree that if any portion of this Agreement is held to be invalid, the balance notwithstanding shall continue in full force and effect. This document shall be binding upon me and my heirs, executors, administrators and assigns.
Print Full Name: ________________________________________________________________
City/State: ___________________________________ Zip:
Phone #:___________________________ Date:________________________
Print Name: __________________________________________________________________