2017 Couch to 5K Participant Release
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Please read waiver and acknowledge you agree to the terms and conditions of the waiver.
Waiver of Liability, Indemnification Agreement and Acknowledgment of
Risks Assumption of Inherent Risks:
a. Physical activity, by its very nature, carries with it certain inherent risks that cannot be eliminated regardless of
the care taken to avoid injuries. I acknowledge that participation in the Couch to 5K program involves jogging,
running and/or walking and can be physically taxing and hazardous to my health (or that of my minor participant).
b. I acknowledge that the inherent risks associated with this event include, but are not limited to, falls, contact with
other participants, broken bones, sprains, cuts and abrasions, dehydration, heat exhaustion/stroke, the potential for
paralysis and/or death, poor road/trail conditions, traffic, high heat/humidity, extreme weather conditions, absence of
water and food on the course, and Acts of God. I further understand that program organizers and volunteers may not
be medically trained and that a delay in the arrival of qualified medical treatment is possible in the event of my
injury during the event.
c. I have read the foregoing and I understand the physical demands this event presents and the inherent risks
associated thereto and affirm that to the best of my knowledge, my physical condition (or that of my minor
participant) is adequate for me (or my minor participant) to participate safely. My participation (or that of my minor)
is voluntary and by signing below I knowingly and completely assume the foregoing risks.
d. I agree to abide by the decision of the instructor in the event the instructor determines that I cannot safely compete
in this event, but I acknowledge and understand that if I compete in the event, the instructor is not making a
determination about my (or my minor child’s) physical ability or condition.
In consideration of being permitted to participate in the Couch to 5K program, I, on behalf of myself, personal
representatives, heirs, spouse, children or assigns, do hereby waive, release, discharge and covenant not to
sue the race organizers, volunteers, or sponsors, including the directors, officers, employees, agents and
independent contractors of the foregoing (collectively referred to as “Released Parties”), from any and all claims for
the ordinary negligence, carelessness, action or inaction of the aforementioned persons or parties to the greatest
extent permitted by the Law of Tennessee. This agreement applies to personal injury, including death, arising out of
my participation in this event.
Indemnification and Hold Harmless
I also agree to HOLD HARMLESS AND INDEMNIFY any or all of the Released Parties from all claims
against them resulting from my negligence, gross negligence or willful or reckless conduct in connection with my
participation (or that of my minor participant) in this event. I further agree to pay Released Parties’s expenses,
including investigation and defense costs, attorneys’ fees and indemnity payments, in the event that I, my spouse,
children or anyone on my behalf, asserts a claim or lawsuit against Released Parties for injuries or damages arising
out of my participation (or that of my minor participant) in this event. I acknowledge this agreement to pay
specifically includes claims or lawsuits brought by, or on behalf of, any minor participant identified
below on this form, including claims brought once the minor reaches the age of majority.
Image and Likeness
I consent to the taking & public or commercial use and dissemination of any photographic or audio-visual images of
me (or my minor participant) taken during my participation in this event and waive any right that I may have to
copyright, inspect or otherwise approve the final project incorporating my likeness.
Severability and Venue
I acknowledge and agree that the foregoing is intended to be as broad and inclusive as permitted by the Law of
Tennessee and that if any portion of this agreement is ruled invalid, it is agreed, notwithstanding, that the remainder
of this agreement will retain its full force and effect. This agreement shall be interpreted and governed by the Law of Tennessee and any legal action arising out of this agreement or my participation in this event must be brought in
Williamson County, Tennessee.
Acknowledgment and Understanding
I have read this description of inherent risks, waiver of liability and indemnity agreement and acknowledge,
represent & warrant that I understand I am giving up substantial legal rights, including my right to sue,
and that (1) I am doing so voluntarily and (2) I am of 18 years or older and of sound mind, or if under 18, have
discussed fully with my parent or guardian. I further agree and acknowledge that my signature below constitutes a
complete assumption of the inherent risks of this event.
Participant acknowledges that he/she has read the waiver and agrees to the terms and conditions.
Yes, I have read and agree to the terms and conditions.
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