Step 1 of 4 (Registration Agreement)

44th Annual Quad-City Times Bix 7

Friday, July 27, 2018 - Saturday, July 28, 2018

  • Jr. Bix

* Click here for fee information

Participant Waiver and Release of Liability Agreement for Minors (Under Age 18)

Participant Waiver and Release of Liability Agreement For Minors (Under Age 18)

In consideration of allowing the Minor identified herein to participate in one or more of the Events described above ("Event") I, for myself, and on behalf of the Minor and the Minor's parents/legal guardians, heirs and next of kin and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to make the following contractual representations pursuant to this Entry Form Waiver and Release of Liability Agreement ("Agreement")

1. I represent (i) I am the parent or legan guardian of the Minor; (ii) the Minor is in good health and in proper physical condition to participate in the Event; and (iii) the Minor is not nor will be under the influence of alcohol or any illicit or prescription drugs which would in any way impair the Minor's ability to safely participate in the Event. I agree it is my sole responsibility to determine whether the Minor is sufficiently fit and healthy enough to participate in the Event. I am responsible for the Minor's safety and well being at all times and under all circumstances before, during and after the Event.

2. I understand the risks and dangers associated with the Minor's participation in road racing which is inherently dangerous and represents an extreme test of the Minor's physical and mental limits. I understand that the Minor's participation involves risks and dangers associated with participation in the Event and related activities, including without limitation, the potential for serious bodily injury, sickness, disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; contact with other participants, spectators, animals or other natural or manmade objects; dangers arising from adverse weather conditions such as heat and humidity; imperfect course conditions; land, water and surface hazards; equipment failure; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Event organizer; and other undefined, not readily foreseeable and presently unknown risk and dangers ("Risks"). I understand these Risks may be caused, in whole or in part, by the Minor's own actions or inactions, the actions or inactions of others participating in the Event, or the negligent acts or omissions of the released parties defined herein. On behalf of the Minor, I hereby expressly assume all such risks and responsibility for any damages, liabilities, losses or expenses which I incur as a result of the Minor's participation in the Event.

3. On behalf of the Minor, I hereby release, waive and hold harmless the following parties: Title Sponsor Quad Cities Times, Cornbelt Running Club, its directors, officers, members and volunteers; the City of Davenport; the Event directors and committees; organizers and promoters; sponsors, advertisers, the facility, venue and property owners or operators upon which the Event including the post Event party takes place; law enforcement agencies, healthcare providers or other public entities providing support for the Event; and each of their respective parent, subsidiary, and affiliated companies, officers, directors, partners, shareholders, members, agents, employees and volunteers (individually and collectively the "Released Parties" or "Event Organizers"), with respect to any liability, claims, demands, cause of action, damages, loss or expense (including courts costs and reasonable attorneys fees) of any kind or nature ("Liability") which may arise out of, result from, or relate in any way participation in the Event including claims for liability caused, in whole or in part, by the negligent acts or omissions of the released parties.
I hereby warrant that I am of legal age, competent to enter into this agreement on behalf of the Minor. I have read this agreement carefully understanding its terms. I acknowledge I am giving up substantial legal rights by signing it (including the rights of the minor, the minor's parent/legal guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns), acknowledge I have signed this agreement without any inducement, assurance or guarantee, and intend for my signature to serve as confirmation of my complete and Unconditional acceptance of the terms, conditions and provisions of this agreement. This agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or inducements have been made apart from this agreement. If any provision of this agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this agreement, and shall not affect the validity and enforceability of any remaining provisions.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

  • I have read, have understood, and do accept the agreement above.
  • I understand that this is a legal document with effects that I approve and authorize.
  • The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
  • I am authorized to agree to the terms of this document on behalf of the registrant.
  • If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

Electronic Signature

Multiple signers should separate their signatures with commas.

This agreement was generated at 10:35:26 PM EDT on 06/18/2018.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 10:35:26 PM EDT on 06/18/2018

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