Waiver of Liability: (Circle One)

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EVENT APPLICATION

Name: ___________________________________________________
Address: _________________________________________________
Date of Birth: ___/___/___ Age: _____ Gender: _________
Contact No._______________________
Event Entering: 5k run 5k walk 5k walk & run (circle one)

Waiver of Liability
Is a potentially hazardous running activity. By signing the entry form and participating in
the Ecumenical Christian College Color Fun Run with a theme of “ECC Flying Color”, I
agree to abide by the rules of this event and certify that I am fully and physically fit to finish the
race, and that I fully accept the Waiver of Liability.

I understand that participating in the event may involve real risk of serious injury or even
death from various causes including but not limited to falls, over exertion, dehydration, contact
with other participants, spectators, road users, effect of weather and condition of the road.

I voluntary assume all the risks associated with my participation in the event or any
activity associated with it. I authorize the use of my name, voice and picture and any information
provided by myself on this entry form to be used without payment in any broadcast, telecast,
promotion on advertising.

I also agree that the information that I have may be used by the event organizer for the
purpose of promoting future and other events for the promotion of face sponsors, production and
services.
In consideration of my entry being accepted, I waive any and all claims for myself, my
administrators, and my heirs against all officials, sponsors, and organizations connected with the
Sesquicentennial Fun Run/Walk for injury or illness that may directly or indirectly result from
my participation in this event. I attest that I have full knowledge of the risks involved in this
event, and am physically fit and sufficiently trained to participate in this event.

___________________________
Applicant Signature

______________________________
Parent Signature over Printed Name
(Participants under 18 years of aged)
ROUTE MAP
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