Humane Society of Henderson County, KY
Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY
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Humane Society of Henderson County, KY
Humane Society of Henderson County, KY
Humane Society of Henderson County, KY
Humane Society of Henderson County, KY

Wag Walk



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Humane Society of Henderson County
5K Wag, Walk, & Run 2012 Registration
HSHC Wag Walk Run
TIMED 5K RACE

Bring your dog!
Medals will be awarded to the top 3 finishers in each age and gender group
All participants will receive and event t-shirt

Check In: 7AM    Race: 8AM
Downtown Central Park, Henderson, KY

Printable Registration Form: wagwalk_registration.pdf

Registraton Fee: $25
First Name: *       
Last Name: *       
   
Email: * 
Phone:      
         
Street 1:* 
Street 2:
City: *    State: *
Zipcode: *       
         
T-Shirt Size:


*NOTICE: By submitting your registration, you concent to the terms and conditions listed below.
Submit Registration
         
TERMS AND CONDITIONS:
ALL PARTICIPANTS IN THIS RACE AND RELATED EVENTS (“EVENT”) ARE REQUIRED TO, AND HEREBY DO, ASSUME ALL RISK OF PARTICIPATION IN THE EVENT BY SIGNING THIS GENERAL RELEASE AGREEMENT.

The undersigned athlete (“Athlete”) on behalf of himself/herself and on behalf of Athlete’s personal representatives, assigns, heirs, executors, and successors hereby fully and forever releases, waives, discharges and covenants not to sue Wag Walk Run, the state in which the event takes place, as well as the town, city and county in which the event takes place, any or all of the charities or organizations affiliated with the Event, all municipal agencies whose property and/or personnel are used or in any way assist and all other sponsoring or co-sponsoring companies, organizations or individuals related to the Event, and the directors, officers, affiliates, employees, representatives, volunteers, sponsors, agents or other relations to such (collectively, the “Releasees”) from any and all liability to the Athlete and his/her personal representatives, assigns, heirs, executors, and successors for any and all loss(es) or damage(s) and any and all claims or demands therefore, on account of injury to the Athlete or property or resulting in the death of the Athlete, whether caused by the active or passive negligence of all or any of the Releasees or otherwise, in connection with the Athlete’s participation in the Event.

The Athlete represents and warrants that he/she is in good physical condition and is able to safely participate in the Event. The Athlete is fully aware of the risks and hazards inherent in participating in the Event, and the Athlete voluntarily assumes these risks. The Athlete attests and verifies that s/he is physically fit and has sufficiently trained for the completion of the Event in which s/he participates and that his/her physical condition has been verified by a medical doctor. It is understood and agreed that Athlete hereby assumes liability for any and all medical expenses incurred as a result of training for and/or participation in the Event, including but not limited to ambulance transport, hospital stays, physician and pharmaceutical goods and services. The Athlete hereby grants full permission to any and all of the foregoing to use his/her name, picture, video, voice, and/or that of my minor children and/or pet (if applicable), without compensation or notice in any broadcast, telecast, advertising, promotion or other account of this event for any purposes whatsoever. The Athlete acknowledges that providing his/her email address on the entry form entitles the Event to email him/her regarding related topics. The Athlete acknowledges that the entry fee paid is non-refundable and non-transferable. The Athlete acknowledges and agrees that the Event and/or agents, in its sole discretion, may delay or cancel the Event if it believes the conditions on the race day are unsafe. In the event the Event is delayed or cancelled for any reason, including but not limited to: fire, threatened or actual strike, labor difficulty, work stoppage, insurrection, war, public disaster, flood, unavoidable casualty, acts of God or the elements (including without limitation, rain, hail, hurricane, tornado, earthquake), or any other cause beyond the control of the Event, there shall be no refund of the entry fee or any other costs of the Athlete in connection with the Event.

The Athlete agrees to hold Wag Walk Run and the Humane Society of Henderson County, KY, their members, directors, officers, agents, volunteers and employees harmless from any claim for loss or injury that may be alleged to have been caused directly or indirectly to any person or thing by the act of other persons, owners, guardians and/or their dog(s) while in or upon the grounds or near any entrance thereto, and the Athlete assumes all responsibility and liability for any such claim. The Athlete represents and warrants that his/her dog is in good physical condition and is able to safely participate in the Event. The Athlete further agrees to hold the aforementioned parties harmless from any claim for loss of our dog(s) by disappearance, theft, death or otherwise, and from any claim for damage or injury to our dog(s), whether such loss, disappearance, theft, damage or injury, be caused or alleged to be caused by the negligence of Wag Walk Run, Humane Society of Henderson County, KY or any of the parties aforementioned, or by the negligence of any other person, or any other cause or causes. Risks may include, but are not limited to, injury or damage caused directly or indirectly as a result of dog fights, dog bites, being knocked-down, chased or tripped, dog(s) being hit by a motor vehicle, etc. The Athlete hereby assumes the sole responsibility for and agrees to indemnify and save the aforementioned parties harmless or this unsupervised facility from any and all loss and expense (including legal and expert witness fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting therefrom, sustained by any person or persons, including myself (ourselves) or on account of damage to property, arising out of or in consequence of my (our) participation Wag Walk Run events or the use of the event location and facilities, howsoever such injuries, death or damage to property or persons may be caused, and whether or not the same may have been caused or may be alleged to have been caused by negligence of the aforementioned parties or agents, or any other persons.

The Athlete agrees to carefully inspect and satisfy myself that the facilities provided are safe for their intended use. Once having conducted the inspection, I agree to expressly assume all risks for myself, guardians, my children and my dog(s) participating at these premises.

I HAVE READ THIS WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SUBMITTING IT.

By my registration above, I state that I (we): 1) agree to the terms and conditions described herein, 2) have read and fully understand the Wag Walk Run rules and regulations (and will explain the same to attending children and guests), and 3) promise to comply fully with all of the conditions of use. I (we) understand that violation of these terms, conditions, rules and regulations may result in suspension or revocation of participation in Wag Walk Run events. I (we) also agree to immediately report any unsafe property conditions to Wag Walk Run event directors.

IF ATHLETE IS UNDER AGE 18: The parent/guardian certifies that my son/daughter has my permission to participate in the Event. The parent/guardian has read the forgoing RELEASE AND WAIVER OF LIABILITY AGREEMENT and by accepting the waiver intentionally and voluntarily agrees to its terms and conditions. The parent/guardian further certifies that my son/daughter is in good physical condition and is able to safely participate in the Event. The parent/guardian authorizes medical treatment for my son/daughter as needed and grants access to my child’s medical records as necessary.



Humane Society of Henderson County, KY
Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY Humane Society of Henderson County, KY
Copyright 2012 Humane Society of Henderson County, KY