RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY, AND PARENTAL CONSENT AGREEMENT FOR 2019 LAW ENFORCEMENT TORCH RUN 
 
In consideration of participating in any portion of the “Law Enforcement Torch Run” event, taking place throughout Northern California in May-June, 2019, (the “Event”), I represent that I understand the nature of the Event and any and all related activities and that I and/or my minor child are competent, qualified, in good health, and in proper physical condition to participate in the Event, including in any and all related Event activities. 
 
I fully understand that the Event and any and all related activities may 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 under which the Event takes place, or the negligence of any of the Releasees named below. I also understand 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 losses, costs, and damages that I and/or my minor child incur as a result of my and/or my minor child’s participation in the Event and any or all related activities. 
 
I hereby release, discharge, and covenant not to sue Special Olympics Northern California, Inc., Special Olympics, Inc., and all other participating entities, including for each their respective administrators, directors, agents, officers, volunteers, and employees, any other participants, sponsors, advertisers, and all owners and/or lessors of any public or private property on which any of the Event activities take place (each considered one of the "Releasees" named herein), from all liability, claims, demands, losses, or damages on my account and/or on my minor child’s 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 and/or on my minor child’s 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, cost, or expense which may incur as the result of such claim(s) or legal action(s). 
I hereby consent to receive any medical treatment which may be deemed advisable for me and/or my minor child in the event of injury and/or illness during the Event and any and all 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 and/or my minor child may suffer in connection with the Event and any and all 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/or my minor child, and to use the same for any legitimate purpose, as well as to use the name and biographical information of me and/or my minor child 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, INDEMNITY, AND PARENTAL CONSENT AGREEMENT. I understand that I have given up substantial rights by signing it 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 minor child, including my and/or my minor child’s heirs, executors, administrators and assigns, and any legal guardian of my minor child.
 
Participant Address: ______________________________________________________________ 
 
City/State:  ___________________________________  Zip:
 
Phone #:___________________________  
 
FOR ADULT PARTICIPANT:
Print Full Name: ________________________________________________________________ 
Signature:_________________________________________Date:________________________
Email:  ________________________________________________________________________
 
FOR MINOR PARTICIPANT:
Print Full Name of Minor:_________________________________________________________
 
Print Full Name of Parent/Guardian: _______________________________________________  
      
Signature:________________________________________________/______________________                
                   (By Parent/Guardian of Minor)                                                            (Date)
 
EMERGENCY CONTACT:
Print Name:  __________________________________________________________________
Phone #:___________________________  

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