WEEKLY RUN/WALK ("THURSDAY NIGHT RUNS") - INDIVIDUAL/FAMILY ENTRY FORM WAIVER AND RELEASE OF LIABILITY

I know that running and/or walking a road race is a potentially hazardous activity. By signing below, I am affirmatively representing that I am in good physical condition, fit to enter and run in these events, and that I am not aware of any medical or health condition, or of any physical defect that would cause me to be unable to participate in weekly runs, or that would otherwise result in injury to myself or others or aggravate any medical, health or physical condition. In consideration of being permitted to participate in weekly runs, I assume all risk associated with running and/or walking in these events including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, or extreme cold; all such risks being known or of which I am aware in which I understood by me, I hereby further understand and knowingly undertake the risks inherent in the conditions of the road in traffic on or near the course. Having read this waiver and knowing these facts, and in consideration of your excepting my entry to participate in the Healthwise Care Center & Physical Therapy ("Healthwise") group run events, l, for myself and anyone in titled to act on my behalf, wave and release Healthwise, their representatives and successors or assigns, and any event sponsors from all claims or liabilities of any kind arising out of my participation in these events even though that liability may arise out of the negligence or carelessness on the part of Healthwise, and further agree to indemnify and hold Healthwise and other sponsors harmless from and against any and all such liabilities, claims, actions, damages, costs and expenses including by way of example, but not limited to, all attorneys' fees, costs of court and the costs and expenses of other professionals in disbursements up through and including any appeal. I authorize medical treatment for me, at my cost, if the need arises. I further give my permission to the event organizers and sponsors to use my name, picture and/or video in any publication, broadcast, telecast or other account of this event without limitation or obligation of further compensation thereof.

I HAVE READ, UNDERSTOOD AND EXCEPT THE CONDITIONS OF THIS (l) LIABILITY RELEASE, INDEMNITY, AND PROMISE NOT TO SUE, AND (Il) AUTHORIZATION AND RELEASE TO USE THE LIKENESS. THIS WAIVER AND RELEASE IS VALID FOR ONE YEAR FROM THE DATE OF SIGNATURE UNLESS EARLIER REVOKED IN WRITING.

This section to be read and signed by parent/legal guardian if participant is a minor:

As the parent/guardian of the above-named participant, I hereby agree to the terms above on behalf of my child, including the waiver of any and all claims, and causes of action, or liabilities which may here after a crew against Healthwise and its affiliates, their agents, employees, volunteers, officers, directors, successors and assigns, and any and all sponsors, their representatives in successors, by reason of my child's participation in said activity. In addition, I accept full responsibility for the care and supervision of my child during the above-described events.