Step 1 of 4 (Registration Agreement)

Crooked Lake Freedom 5

Thursday, July 4, 2019 in Angola, IN at Steuben County 4H Park

  • 5K
    18 and under will receive a $5 discount on registration at checkout.

  • 5 Mile
    18 and under will receive a $5 discount on registration at checkout.

* Click here for fee information

Event Waiver

Waiver:I understand and accept that running a race is a potentially hazardous activity. I know that I should not enter and run unless I am medically able and properly trained. As such I affirmatively represent that I am physically and medically able to participate in this event. I agree to abide by any decision of race officials, law enforcement representatives and/or volunteers relative to my ability to safely complete the run, however I understand that those individuals are not and cannot be responsible for determining whether or not I am able to participate and I hereby release and hold such individuals and their agents and/or representatives and/or successors or assigns, absolutely harmless for any and all injury and/or damage I may suffer which relates and/or is connected in any way with this race event. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, bicycles and vehicular traffic, injuries or illness from animals or plants, the effects of weather and all risks associated with event participation. Having read this waiver and knowing these facts and in consideration of you accepting my entry, I, for myself, my heirs, assigns, successors, personal representatives and/or all other persons entitled, or claiming to be entitled, to act on my behalf, waive and release, discharge and hold absolutely harmless the Crooked Lake Association, its officers, directors, board members, representatives, successors, designees and/or assigns, all race officials and agents, all clubs and sponsors, their representatives and successors, of and from any and all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I understand, consent to, and accept that participants who do not follow course rules, general good sportsmanship or race day guidelines, regulations or rules, face potential disqualification and loss of eligibility for future events. ADDITIONAL AGREEMENT WITH THE CROOKED LAKE ASSOCIATION FOR ASSUMPTION OF RISK, INDEMNIFICATION, RELEASE, AND CONSENT FOR EMERGENCY TREATMENT: In consideration of my voluntary participation in the Crooked Lake Freedom 5, I affirmatively represent that I have carefully read, and fully understand, each of the following paragraphs. I understand that if I wish to discuss any of the terms contained in this agreement, I may contact Trishia Stites at 260-438-0842. Assumption of Risks: I understand that the physical activity of the Crooked Lake Freedom 5, by its very nature, includes certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. Some of these involve strenuous exertion, using various muscle groups, and the risk of tripping, falling and/or otherwise suffering serious physical injury. The specific risks vary, but range from: 1) minor injuries such as scratches, bruises, and sprains, to 2) major injuries such as fractures, internal injuries, joint, neck or back injuries, blood clots, heart attacks, and concussions, to 3) catastrophic injuries including paralysis and even death. I understand and appreciate the risks that are inherent in the Crooked Lake Freedom 5. I hereby assert that my participation is voluntary and that I knowingly assume and accept all such risks. I further understand that I am ultimately responsible for my own safety. Hold Harmless, Indemnity and Release: In consideration of my participation in the Crooked Lake Freedom 5, I agree, for myself, my heirs, personal representatives or assigns, to defend, hold absolutely harmless, indemnify and release, the Crooked Lake Association, its representatives, members, officers, agents, successors, assigns, designees and volunteers (the "Released Parties") from any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property or personal injury or death which may result from my participation in the Crooked Lake Freedom 5. This release includes, but is not necessarily limited to, claims based on the negligence of the Released Parties, but expressly does not include claims based on their intentional misconduct or gross negligence. I understand that by agreeing to this clause I am releasing claims and giving up substantial rights, including my right to sue. Consent for Emergency Treatment: I authorize the Crooked Lake Association and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any qualified medical professional. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization, and I further hereby agree to hold absolutely harmless, defend and indemnify the Released Parties again any such financial responsibility. Photo and Video Consent, Waiver, and Release I further consent and give permission to allow the Released Parties and/or the Crooked Lake Association, its successors and assigns and all persons acting under its permission or authority, the right to photograph and video record me and to transmit, use, copy, publish, copyright, distribute, and display photographic portraits, photographic likenesses, or pictures, or video recordings of me in connection with exhibitions, publicity, advertising, educational, and promotional materials, including broadcast over the Internet or television or similar media without reservation or limitation. I may be included in the video broadcasts, portraits, or photographic likenesses or pictures in whole or in part, in composite or distorted form, with or without my name, in color or otherwise, made through any medium. I waive any right that I may have in regard to such video recordings, photographic portraits, or photographic likenesses or pictures, including the right to any royalty and the right to inspect or approve any finished product or the advertising or other copy that may be used in connection with a product or the use to which it may be applied, including the right to post or publish on the Internet. I release and discharge the Released Parties and the Crooked Lake Association, its successors and assigns and all persons acting under its permission or authority, from any and all claim or cause of action, now known or later discovered, for, among other things, invasion of privacy, right of publicity, and defamation arising out of the use and exploitation of the photographic portraits, photographic likenesses, or pictures, or video recordings of me. Further, by signing this consent, waiver, and release form, I acknowledge that I understand and agree to the above request and conditions. I sign this form freely and without inducement. By signing this form, I represent and warrant that I am over 18 years of age and/or that I am the legal parent or guardian of the participant referenced herein and registering hereby and that sign on behalf of such minor participant.
By agreeing to this waiver you submit to the terms and conditions as set forth by this event and certify that you have provided true and accurate information as requested through this registration process.

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

You must be 18 years of age to legally complete this registration. If the registrant is under 18, an authorized adult must complete this form.
If the person you are registering (registrant) is under 18, do not enter his/her age. You will do that on the next step. Enter your age here as the person completing the form.

Multiple signers should separate their signatures with commas.

This agreement was generated at 11:08:58 PM EDT on 05/23/2019.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 11:08:58 PM EDT on 05/23/2019

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