Eagle Fest......

Eagle Fest Color Run 5k Run/Walk Registration Form

Sat., May 19th, 9:00 a.m.  Summit Parkway Middle School

• All participants require a registration form and entry fee
• Entry fee: $15 per person
• Registration forms can be sent in with students and turned in to their home room teacher or the front office.
• The walk/run is 3.1 Miles and will be located on SPMS campus
• You can also register online with a credit card @ https://eaglecolorrun-walk.eventbrite.com
• Race day registration begins at 8:15 am. Race Day t-shirts limited to the first 100 registrations
• Course not stroller friendly

Participant Name ______________________________________________

Grade Level ________________                   HR Teacher _____________________

Phone Number___________________          Email ____________________________

Age ___________      M/F _________   Shirt Size (circle one)   S  M   L  XL  2XL 

(Race Day T-shirt limited to first 100 to register)

Eagle Fest Color Run 5k

Parent/Guardian Permission & Participant Waiver

As the parent or guardian of the student listed below (“Child”), I hereby understand and agree that:

1. Events – My Child and I expressly assume all risks, including potential personal injury and fatality, which may arise out of my Child’s participation in any school events that are sponsored by or affiliated with Summit Parkway Middle School. Such events may include but are not limited to the Eagle Festival event and any other similar sponsored activities that my Child’s school may offer (“Events”).
2. Being Prepared – It is my sole responsibility to ensure that my Child’s clothing and any equipment are properly fitted and appropriate for use in any Event, and that my Child is physically fit and able to participate in any Events. Prior to any Event, I will instruct my Child to stop and request assistance if he/she experiences any adverse physical symptoms such as, but not limited to, dizziness, excessive fatigue, shortness of breath, pain or any other conditions that would make it difficult or unsafe to continue the Event.

Release and Indemnity Agreement

I agree, for myself, my Child/Ward, and our heirs, executors and administrators, to not sue and to release, indemnify and hold harmless SPMS, its affiliates, officers, directors, volunteers and employees and all sponsoring businesses and organizations and their agents and employees, from any and all liability, claims, demands, and cause of action whatsoever, arising out of my Child’s participation in any Summit Parkway MS sponsored Events and related activities whether it results from the negligence of any of the above or from any other cause. This agreement shall be as broad and inclusive as is permitted by the State in which the event is conducted. If any portion of it is held invalid, the balance shall continue in full force and effect. I have read, understand and agree to the terms of this Release and Indemnity Agreement.

Media Release

I authorize the use, copyright or publication of my Child’s name, image or voice while participating in any Event and related activities, as may be captured by photograph or recording in any medium for any purpose, including illustration, promotion or advertisement.

I am the parent or legal guardian of the participant, and I hereby consent to his/her participation in Events and related activities. I have read and explained this form to Child, and hereby agree to all of its terms and conditions on behalf of myself and my Child.

____________________________________________________

Parent/Guardian's Printed Name

____________________________________________________

Signature                                                            

___________________________________________________

Date

___________________________________________________

Student's Printed Name