Night Runners WPB
New Participant Registration
Waiver of Liability
I, the participant, intending to be legally bound do hereby waive and forever release any and all right and claims for damages or injuries that I may have against Night Runners WPB Inc., its Directors, and all of their agents, sponsors, representatives, volunteers and employees for any and all injuries to me or my personal property. This release includes all injuries and/or damages suffered by me immediately preceding, during or immediately after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.
COVID-19 Disclaimer
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may exposed to COVID-19 by my mere participation in this activity and such exposure or infection in personal injury, illness, permanent disability and death. I understand the risk of becoming exposed to infected by COVID-19 may result from the actions, omissions or negligence of myself. I hereby release the Night Runners WPB from any and all claims arising from or in connection with any direct COVID-19 impact while participating.
Signature
*
Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Race/Ethnicity
Caucasian
African-American
Latino or Hispanic
Asian
Native American
Native Hawaiian or Pacific Islander
Two or More
Prefer not to say
Other
Gender Identity
Male
Female
Transgender (unspecified)
Non-binary
Prefer not to say
Other
I'd like to...
Walk
Run
Train
Socialize
How did you hear about Night Runners WPB
Returning Member
Social Media: Facebook
Social Media: Instagram
Social Media: MeetUP
Word of Mouth
Night Runners WPB 5K
Compass Community Center
Front Runners and Walkers of Fort Lauderdale
Fit2Run Palm Beach Gardens
Other
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