Parent/Guardian Name * *

First Name

Last Name

Parent/Guardian Phone *

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Participant Name *

First Name

Last Name

Participant Date of Birth *

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

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WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT * *

1. Acknowledgment of Risk: I, the undersigned parent or legal guardian, hereby acknowledge that participation in the activities of Lonely Legends Track Club, including but not limited to practices, training sessions, conditioning, meets, and travel, involves inherent risks. These risks include, but are not limited to: physical injury (including serious bodily harm or death), illness, exposure to inclement weather, transportation accidents, and damage to personal property. 2. Assumption of Risk: I voluntarily assume full responsibility for any risks of loss, property damage, or personal injury that may be sustained by my child, or any loss or damage to property owned by me or my child, as a result of participation in the Lonely Legends Track Club and related events and activities, whether caused by the negligence of the organizers, staff, volunteers, or otherwise. 3. Release and Waiver: In consideration of my child being permitted to participate in any way in the Lonely Legends Track Club, I hereby release, waive, discharge, and covenant not to sue Lonely Legends Track Club, its owners, coaches, volunteers, officers, agents, sponsors, and affiliated entities from any and all liability, claims, demands, actions, or causes of action of any kind arising out of or relating to participation in the program. 4. Medical Treatment Authorization: I authorize any representative of Lonely Legends Track Club to seek medical treatment for my child in the event of an emergency. I understand that I am responsible for all medical expenses incurred as a result of any injury or illness sustained by my child while participating in club activities. 5. Insurance: I understand that it is my responsibility to provide health insurance coverage for my child. I acknowledge that the Lonely Legends Track Club does not provide health or accident insurance for participants. 6. Indemnification: I agree to indemnify and hold harmless Lonely Legends Track Club and its representatives from and against any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney’s fees, brought as a result of my child’s involvement in the program and to reimburse them for any such expenses incurred. 7. Photographic Release: I grant permission for Lonely Legends Track Club to use photographs and/or video of my child taken during practices, events, or competitions for promotional purposes, including on the club’s website, social media, or printed materials. I understand that no compensation will be provided. 8. Governing Law: This agreement shall be governed by and construed in accordance with the laws of the State of Georgia. BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THIS WAIVER OF LIABILITY AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS ON BEHALF OF MYSELF AND MY CHILD.

I agree

Date of Signature *

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