Longboat Toronto Island Run
 
First Name
Last Name
Address
Apt #
City
Postal Code
E-mail
Telephone #
Event 5Km    10Km   5Km Competitive Walk    5Km Walk Team
5km Walk
Team Name
Walker #   1   2   3   4
Sex   Male Female          Age on Sept 9/08
T-shirt Size   S M L XL
ORA/OTFA #     Amount Enclosed

Release, Waiver and Indemnity

In consideration of the acceptance of my application and the permission to participate as an entrant or competitor in the 28th annual Longboat Toronto Island 5K and 10k Run and 5K walk, to be held on September 21, 2008, I, for myself, my heirs, executors, administrators and assigns HEREBY, RELEASE, WAIVE and forever discharge the City of Toronto, the Longboat Roadrunners, the Ontario Track and Field Association, Ontario Road Runners Association, and all other associations, sanctioning bodies and sponsoring companies and all their respective agents, officials, servants, contractors, representatives, elected and appointed officials, successors and assigns OF AND FROM ALL, claims, demands, damages, costs, expenses, actions and causes of action, whether in law or equity, in respect of death, injury, loss or demand to my person or property HOWSOEVER CAUSED, arising or to arise by reason of my participation in the said event, whether prior to, during or subsequent to the event AND NOTWITHSTANDING the same may have been contributed to or occasioned by the negligence of any of the aforesaid. I FURTHER HEARBY UNDERTAKE to HOLD AND SAVE HARMLESS and AGREE TO IDEMNIFY all the aforesaid from and against any and all liability incurred by any or all of them arising as a result of, or in any way connected with my participation in the said event. BY SUBMITTING this ENTRY, I ACKNOWLEDGE HAVING READ, UNDERSTOOD AND AGREED to the WAIVER, RELEASE and INDEMNITY. I WARRENT that I am physically fit to participate in this event.

Print Name Date

 

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Signature.     If participant is under 18 years of age, parent or guarian must sign.

Make cheque payable to:  Longboat Roadrunners, 234 Indian Rd, Toronto, Ontario M6R 2W9