Popsicle Race Series Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Each Wednesday from 9/9/20 to 9/30/20

Email *

Participant Name *

Race distance (can be change during series) *

1k (typically pre-K - 2nd grade)

2k (typically 3rd - 5th grade)

3k (typically 6th - 8th grade)

School or club affiliation *

TNHS / Renegade Running

NCHS / East Nelson Run Club

Bethlehem Prep

Bardstown

Unsure/unattached

Other:

What races do you plan to you attend? *

9/9 Thomas Nelson

9/16 St. Thomas

9/23 Thomas Nelson

9/30 Nelson County

Required

In consideration of you accepting this entry, I, the participant (or a parent or adult guardian for all children under 18 years), intending to be legally bound do hereby waive and forever release any and all rights and claims for damages or injuries that I (or a parent or adult guardian for all children under 18 years) may have against the Event Director, Nelson County Schools, Bardstown City Schools, Bethlehem High School, and all of their agents assisting with the event, sponsors and their representatives, volunteers and employees for any and all injuries to me (or a parent or adult guardian for all children under 18 years) or my personal property. This release includes all injuries and/or damages suffered by me before, during or after the event. I (or a parent or adult guardian for all children under 18 years) recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.I (or a parent or adult guardian for all children under 18 years) know that running a cross country race is a potentially hazardous activity. I (or a parent or adult guardian for all children under 18 years)should not enter and run unless I am medically able to do so and properly trained. I (or a parent or adult guardian for all children under 18 years) assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, and course conditions, and waive any and all claims which I might have based on any of those and other risks typically found in running a cross country race. I (or a parent or adult guardian for all children under 18 years) acknowledge all such risks are known and understood by me. I (or a parent or adult guardian for all children under 18 years) agree to abide by all decisions of any race official relative to my ability to safely complete the run. I (or a parent or adult guardian for all children under 18 years) certify as a material condition to my being permitted to enter this race that I am physically fit and sufficiently trained for the completion of this event and that a licensed Medical Doctor has verified my physical condition.In the event of an illness, injury or medical emergency arising during the event I (or a parent or adult guardian for all children under 18 years) hereby authorize and give my consent to the Event Director to secure from any accredited hospital, clinic and/ or physician any treatment deemed necessary for my immediate care. I (or a parent or adult guardian for all children under 18 years) agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medications, treatment and hospitalization.As it applies to my participation in this race, I (or a parent or adult guardian for all children under 18 years) agree to abide by the Center for Disease Control (CDC)’s recommendations for the prevention of the spread of COVID-19 and attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I (or a parent or adult guardian for all children under 18 years) also agree to abide by any COVID-19 distancing and other safety guidelines issued by the state, the community or by this race for my participation in this race.This event follows the standard running industry policy. We reserve the right to postpone or cancel the event due to circumstances beyond our control such as a weather or emergency or as required to protect the safety of participants and staff. By submitting this entry, I acknowledge (or a parent or adult guardian for all children under 18 years) having read and agreed to the above release and waiver. *

I acknowledge that I have read and understand the waiver.

Required

Parent Signature *

By signing below, I agree to adhere to all Covid-19 safety protocols on site. I agree to wear a mask. I agree that there is to be only one adult per family in the event venue. *

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Nelson County Schools. Report Abuse

Forms