Step 1 of 4 (Registration Agreement)

Cornbelt Running Club - Membership

in Davenport, IA at 315 East George Washington Blvd.

  • Student Membership



  • Adult Membership





  • Family





  • Sponsor





* Click here for fee information


Event Waiver and Release of Liability

WARNING: READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF LEGAL RIGHTS AND DEPRIVES YOU OF THE RIGHT TO SUE THIS ORGANIZATION AND OTHER PARTIES. DO NOT SIGN THIS AGREEMENT UNLESS YOU HAVE READ IT IN ITS ENTIRETY. SEEK THE ADVICE OF LEGAL COUNSEL IF YOU ARE UNSURE OF ITS EFFECT.

Admission of Risk and Liability Release:
In submitting this application, I acknowledge that I am assuming risks, and agreeing to indemnify, not to sue and release from liability Cornbelt Running Club, its officers, board of directors, members and volunteers, in the case of any accident, injury, or damage of any kind . I recognize that running is potentially dangerous, and I represent that I am a competent runner. I understand that I participate in club activities at my own risk. I further recognize that safety is my personal responsibility and I agree to participate in keeping all runs as safe as possible by obeying applicable traffic laws. I agree to hold the club (run, event) harmless and indemnify the club (run, event) for all costs, judgments and awards that may be claimed including the cost to defend such claims brought by you or another in your behalf or that of others.

FOR MINORS: Parent or Guardian must agree to this waiver:
I am the parent or guardian of the above listed Applicant, and assure CBRC that the facts and responsibilities listed above concerning my child or ward are true. By agreeing to this form I am giving my permission for my child or ward to participate in CBRC events and activities. I agree to the terms of the above listed Admission of Risk and Liability Release whose terms bind me, my child, my heirs, legal representatives and assignees.

For my children not considered adequately competent to run on city streets, county roads, state highways, shared paths, I will accompany them on club runs. If you are older than thirteen, but not yet eighteen or you are incapacitated and/or mentally challenged, please have a parent or legal guardian note their acceptance of the terms of registration by providing their initials where indicated below. If you are at least eighteen, please enter your own initials where indicated below. I understand that this Waiver and Release may be stored electronically and agree that a copy is authentic and admissible as evidence in any future dispute or proceedings.



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 9:27:11 PM EST on 12/14/2017.







Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 9:27:11 PM EST on 12/14/2017


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