5K Walk/Run Participant Registration

  • Please print legibly. One participant per form. All fields are required. Signature required.
  • Release of all claims & promise not to sue: As a participant in this and any other program of the Berkshire South Regional Community Center, I recognize and acknowledge that there are certain risks and I agree to assume all such risks, including any damage resulting from physical injuries, loss of services or consortium, loss or damage to property, or any other loss I may sustain as a result of participating in any and all activities connected with or associated with such programs. In consideration of the Berkshire South Regional Community Center accepting my or my child’s registration, and with the intent to be legally bound, hereby, for myself, for my child, all heirs, executors, administrators, and assigns, do hereby forever release, waive and relinquish all claims I have or may have as a result of participating in this and all other programs of the Berkshire South Regional Community Center. Furthermore, I promise not to sue the Berkshire South Regional Community Center and agree to indemnify and hold harmless and defend the Berkshire South Regional Community Center and its officers, agents, servants, employees and insurers from any and all liabilities, claims, demands, actions or causes of action resulting from my or my child’s participation in this or any other programs of the Berkshire South Regional Community Center. By signing this form, I hereby acknowledge that all information contained herein is true and correct and that I may give up legal rights.
 

Signature of Acknowledgement