Michael Haseltine
Scholarship Fund
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Child (Minor) Release and Waiver of Liability
I am the parent or guardian of the minor child whose name appears below (“Child”), and I am signing this Agreement because I want my Child to participate in the 1st Ability 5K Run, Walk and Roll (the “Road Race”). I acknowledge that participation in the Road Race will involve my child in, without limitation, running in vehicular traffic on the course route and the possibility of being struck by a vehicle, the possibility of collision with other participants, running on road surfaces that are not properly maintained or are inherently unsafe, being exposed to the prevailing weather (which may cause road surfaces to be unsafe), the potential for falls, and the potential for a heart attack or other damaging health event attributable to strenuous activity, and that such participation is generally an inherently dangerous and hazardous activity. I understand the risk that my Child or other participants in the Road Race might become ill, be injured, or die, and I understand the risk of damage to property, belonging to my Child or others, that arise from participation in the Road Race. Nonetheless, I assume full responsibility for all such risks. My Child is in good health, and I know of no reason why my Child is not capable of participating safely in the Road Race. I agree to abide by all decisions of Road Race officials relative to my Child’s ability to safely complete the Road Race.
I agree that my Child will observe and comply with all Road Race rules and regulations, whether posted on the Road Race course or elsewhere, and I agree that my Child will comply with all decisions and requests of Road Race officials. Without limiting the generality of the preceding sentence, I understand that no headsets, roller skates, dogs, skateboards or motorized vehicles are allowed on this course, and I agree that my Child will comply with these restrictions.
In consideration of the opportunity for my Child to participate in the Road Race, I, on behalf of myself, my Child, my and my child's heirs and personal representatives, hereby covenant not to sue regarding and waive any and all claims against Developmental Disabilities Services of Jackson County - EITAS and Kansas City, Missouri (including the Kansas City Police Department), which are the principal sponsors of the Road Race (the “Principal Sponsors”), all elected officials, directors, officers, and employees of such Principal Sponsors (the “Principal Sponsor Personnel”), all volunteers who work at the Road Race (the “Volunteers”), and all persons who make donations or sponsorship payments in support of the Road Race (the “Race Sponsors”) for or relating to any illness or injury that my Child might suffer, for my Child’s death, and for any damage to me or my Child’s property that may arise or result from or that relates in some way to my Child’s participation in the Road Race. In addition, I, on behalf of myself, my and my child's heirs and personal representatives, hereby release and forever discharge the Principal Sponsors, the Principal Sponsor Personnel, the Volunteers, and the Race Sponsors from liability for any such claims or demands, regardless of the negligence of any such person. I intend for this waiver, release, and discharge to be as broad and inclusive as applicable law permits.
I grant permission to each of the Principal Sponsors to use my Child’s name and likeness in any photographs, videos, recordings, or any other record of the Road Race, royalty-free and in perpetuity, in advertising, promotional, informational, or marketing materials related to such Principal Sponsor and its mission.
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