Covering: 2015 Happy Feet Run & Walk for Republic Pregnancy Resource Center (Event).
I, , understand that my, or my minor child, or the minor child in my legal custody's participation in the
Event is at my own risk. I understand there are risks associated with physical activity involved in the Event, including
but not limited to possible falls, contact with other participants, effects of weather, traffic, and road conditions.
I understand that, in the event
that (participant's name) requires medical or dental treatment
while engaged in the activity, reasonable efforts will be made to contact me; however, if I cannot be
reached, I hereby consent and give my permission to the Event's sponsor or any adult counselor acting on behalf
of the ministry with respect to the Activity, as agent for me, to consent to any X-ray examination, injections, anesthesia,
medical, dental, or surgical diagnosis and treatment; and hospital care and treatment advised and supervised
by a physician, surgeon, or dentist licensed to practice under the laws of the state where the services are
rendered, either as on outpatient or in any hospital.
I understand that my insurance coverage for myself or my child will be used as primary coverage in the
event medical intervention is needed. Coverage by Calvary Baptist through its accident policy may be available
as a backup for what my family's insurance does not cover.
I understand all reasonable safety precautions will be taken at all times by Calvary Baptist and RPRC and
its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent
possibility of risk. I also agree not to hold Calvary Baptist, RPRC, leaders, employees, and volunteer staff
liable for damages, losses, diseases, or injuries incurred during participation in the activities and events.
I also understand that visual and audio recordings may be made of these activities, and can be used by as
needed for publicity, announcements, scrapbooks, etc.
I also recognize that by signing this waiver there is no right to a refund if I am unable to attend the race.
Pregnancy Resource Center!!