PLEASE CHECK BOX. Release form and contribution agreement: In consideration of my accepting this entry, I hereby for myself, my heirs, executors and administrator, waive and release any and all claims and damages I may have against The Vanessa T. Marcotte Foundation and its employees, volunteers, representatives, and consultants, including the Marcotte Family and Take Root Advisors, for any and all injuries suffered or sustained by me in said event and in the training of said event or travel to and from (if applicable) any of the preceding. I further attest that I am physically fit and have sufficiently trained for competition in this event. I also grant permission for use of my name and/or photograph or voice in broadcast, telecast, print or any other account of this event and agree to waive compensation for such use. If selected, I will complete the ASICS Falmouth Road Race supplemental race registration-there is no registration fee required for charity runners. I agree to collect a fundraising minimum of $750 for The Vanessa T. Marcotte Foundation, or $300 if I already have an entry through other official means, by August 20, 2022. I fully understand that once I register for the race, I am obligated to complete the fundraising even in the event of injury or not being able to participate for any reason. I fully understand that the foundation reserves the right to charge the balance I owe (if any) to my credit card. I declare that I have exercised my own judgment in signing this agreement and I further declare that the decision to sign this agreement is my own. *