Firefighter Challenge Registration Form 

(registration will be open until the event starts)

The Victim Drag - Pick up a life-size mannequin from the ground, grab it from behind, and drag it backward for a pre-determined distance.

Ladder Throw - The competitor must raise and place a ladder onto the side of a structure.

Keiser Sled - The competitor stands over a large heavy beam. They must slam a sledgehammer into a weight until the weight moves the length of the sled.

Hose Line Drag - The competitor sprints a pre-determined distance with an uncharged hose while going around and through obstacles.

Hose Hoist - Using a hand-over-hand motion, the competitor must raise a hose roll and lower it back to the ground.

This will be a timed event with each event above being completed consecutively for a single time.

WAIVER AND RELEASE OF LIABILITY

IN CONSIDERATION OF the risk of injury that exists while participating in the FIREFIGHTER CHALLENGE (hereinafter the "Activity"); and my desire to participate in said Activity and being given the right to participate in same;

I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," " or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity: and

I HEREBY release and forever discharge WEST MANCHESTER TOWNSHIP FIRE DEPARTMENT located at 2190 Carlisle Rd, York, Pennsylvania 17408, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releasees"), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S NONETHELESS, IASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.

I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever forliability, damages, compensationor otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs.

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, authorize WEST MANCHESTER TOWNSHIP FIRE DEPARTMENT to provide all emergency medical care deemed necessary. including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE WEST MANCHESTER TOWNSHIP FIRE DEPARTMENT AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST WEST MANCHESTER TOWNSHIP FIRE DEPARTMENT FOR PERSONAL INJURY OR PROPERTY DAMAGE.

To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of WEST MANCHESTER TOWNSHIP FIRE DEPARTMENT its agents, and employees.

I AGREE that this Release shall be governed for all purposes by Pennsylvania law, without regard to any conflict of law principles. In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in fullforce and effect. If acourt should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provisionit would beco me valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THATI AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY.IAM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THATI AM SIGNING IT OF MY OWN FREE WILL.

 

In the event that the participant is under the age of consent (18 years of age), then this release must be signed by a parent or guardian, as follows: IHEREBY CERTIFY that I am the parent or guardian of participant named above, and do hereby give my consent without reservation to the foregoing on behalf of this individual.