APPLICANT INFORMATION FORM AND RELEASE OF LIABILITY- ACT RUNNING LLCDisclosure: Appreciation of Risk involved in Race/Sport/Training/Team-Building/Challenge Course/Group Runs and Media Release:ACT Running LLC programs involve a variety of activities that often include warm-up, games, group initiative problems, low and high challenge course elements and other rigorous physical adventure activities. The level of participation in all programs and activities is at all times completely up to the individual. Yet there is a risk which must be assumed by each participant that he or she may suffer an emotional or physical injury and disability. Policy for participation in all ACT Running LLC programs requires that every participant have health/accident insurance coverage. In addition, certain health/medical information must be made known to the instructors/volunteers conducting programs so that they are prepared to respond appropriately if the need arises. This information will be held in confidence. Challenge by ChoiceRunning, walking events/activities and team-building programs are composed of activities that may be very unfamiliar to all participants. To assure our participants control over their own personal safely, we have adopted the philosophy of “Challenge by Choice”. At all times, participants in ACT Running LLC activities are completely in control of their own level of participation. During our programs you only need to do or attempt to do only those things that you choose. You must listen carefully to all instructions and briefings, set your own goals free of the influence of the group’s goals, make a decision as to your level of participation and inform others of your choice.You must be aware/accept responsibility for possible risks in this program:I, the undersigned, assume and understand that there are inherent risks of bodily injury and even death or damage to property, that are not the fault of ACT Running LLC that accompany my participation in ACT Running LLC activities. I acknowledge and agree that participation in the activities and training exposes me to risks including, but not limited to, falls, running-related injury, conditions of the road and traffic, contact with other participants, effects of weather, high-heat and/or humidity, and any other such risks, known and unknown. I know that running is a potentially hazardous activity and certify that I am in good health and physically fit to enter into an activity or training program and that my physical condition has been verified by a licensed Medical Doctor. I acknowledge that I am aware of the many risks of injury or other conditions involved in athletic training in general and running training specifically, including conditions or injuries which could be life threatening. I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in training for and participating in road, trail and track running and racing and any conditioning and cross training activities associated with that training. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.Indemnification and Hold Harmless: I also agree, at my own expense, to INDEMNIFY AND HOLD HARMLESS ACT Running its agents, representatives, mentors, volunteers, sponsors, successors and family from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney's fees brought as a result of my involvement in ACT Running's program.Severability: I further expressly agree that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity, and responsibility agreement above, fully understand its terms, and I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am accepting the agreement freely and voluntarily, and intend by my registration to be a complete and unconditional release of all liability to the greatest extent allowed by law. I further grant ACT Running LLC and ACT Running LLC persons acting for or through them , the right to use, reproduce, assign and/or distribute photographs, films, videotapes, and sound recordings of myself for use in materials/marketing they may create. I am at least eighteen (18) years of age and fully competent and I execute this waiver of liability for full, adequate, and complete consideration fully intending to be bound by the same. This agreement shall be governed by the laws of the State of Texas and enforced by the courts therein.GROUP WAIVERAcknowledgement of Understanding: I acknowledge that I have read the attached Waiver of Liability, Assumption of Risk, and Indemnity Agreement and fully understand its terms. I affirm that I am voluntarily participating in the ACT Running LLC event and further acknowledge that I know, understand, and appreciate the inherent risks of the ACT Running LLC Event. I assume full responsibility for any and all injuries or damages which may occur to me as a result of the inherent risks associated with ACT Running LLC event.I understand and agree to the Waiver of Liability, Assumption of Risk, and Indemnity Agreement *