Step 1 of 4 (Registration Agreement)

Interlock 5K - Race for Autism

Saturday, April 25, 2020 in Muncie, IN at Delaware County Fairgrounds Heartland Building

  • 5K

* Click here for fee information

Interlock 5K Waiver and Release

In consideration of being allowed to participate in any way in the Interlock 5K the undersigned:

Agrees that prior to participating, they will inspect the facilities and equipment to be used, and if they believe anything is unsafe, they will immediately advise race managers and refuse to participate.

Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including severe stress, permanent disability, or death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence, by the actions, inactions or negligence of others, the rules of play, vehicle traffic on the course, or the condition of the premises or any premises or any equipment used. Further, there may be other risks not known or reasonably foreseeable at this time. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.

Release, waive, discharge and covenant not to sue RaceMaker Productions, and the Interlock 5K race committee or Interlock of East Central Indiana, their officers, directors, members, sponsors, volunteers, employees, the municipality of Muncie, Indiana, Delaware County Fairgrounds, Cardinal Greenway; including any and all claims for damage caused by the negligence of any of them, other participants, sponsoring agencies, advertisers, and owners and lessors of premises used to conduct the event, all of which are hereafter referred to as releases, from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses, or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during the Interlock 5K.

I hereby give permission to Interlock of East Central Indiana and RaceMaker Productions LLC to use photos/videos of me and quotations from me in legitimate promotions and media accounts of this event.

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 7:53:01 PM EST on 02/21/2020.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 7:53:01 PM EST on 02/21/2020

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