June 6, 2015
1035 Avalon Dr.
Forest, VA 24550
5k registration fee $25
1k has a $5.00 minimum donation
T-Shirt for $10.00 (Deadline for shirts is May 23)
*All race participants will receive a challenge coin
Start Time 5K: 8:00 am
Start Time 1K: 9:00 am
The Lynchburg Area Veterans Council would like to help the 40% of Veterans within our community that cannot afford to pay for transportation services to their medical appointments. The proceeds from our event will be used towards transportation vouchers for wheelchair bound Veterans within Amherst County, Bedford City/County, Campbell County, and Lynchburg City to medical appointments to the Lynchburg CBOC and Salem VA. This will allow them to get the medical attention they deserve.
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RELEASE AND WAIVER OF LIABILITY AGREEMENT:
ECO-X REGISTRATION AGREEMENT AND LIABILITY WAIVER (the "Agreement and Waiver")
1. Authority to Register and/or to Act as Agent. You represent and warrant to eco-x, Inc. ("eco-x") that you have full legal authority to complete this event registration on eco-x, including full authority to make use of the credit or debit card to which registration fees will be charged. In addition, if you are registering third parties, you represent and warrant that you have been duly authorized to act as agent on behalf of such parties in performing this event registration. By proceeding with this event registration, you agree that the terms of this Registration Agreement shall apply equally to you and to any third parties for whom you are acting as agent. If you are registering a child under the age of 18 or an incapacitated adult you represent and warrant that you are the parent or legal guardian of that party and have the legal authority to enter into this agreement on their behalf and by proceeding with this event registration, you agree that the terms of this Agreement and Waiver shall apply equally to all Registered Parties. Compliance with Children's Online Privacy Protection Act (COPPA). You represent and warrant that, in compliance with COPPA, you are over thirteen (13) years of age, and that if you are registering a child under fourteen (14) years of age you are the parent of such child, and do hereby consent to the collection of such child's personal information by eco-x.
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BY INDICATING YOUR ACCEPTANCE OF THIS AGREEEMENT AND WAIVER, YOU ARE AFFIRMING THAT YOU HAVE READ AND UNDERSTAND THIS AGREEMENT AND WAIVER AND FULLY UNDERSTAND ITS TERMS. YOU UNDERSTAND THAT YOU ARE GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. YOU ACKNOWLEDGE THAT YOU ARE SIGNING THE AGREEMENT AND WAIVER FREELY AND VOLUNTARILY, AND INTEND BY YOUR ACCEPTANCE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
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You must agree to these terms in order to proceed with your registration.
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I know that running is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I hereby certify that I am in good health and I have trained to run the distance of the race, which I am entering. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry into this running race, I, for myself and anyone entitled to act on my behalf, waive and release the Veterans Counsel., its officers, directors, agents, volunteers and employees, all states, cities, counties, the Metropolitan District Commission or other governmental bodies or locations in which events or segments of events are held, all sponsors, their representatives and successors, from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. I understand that bicycles, skateboards, roller skates or inline skates and animals are not allowed in the event and I will abide by this policy. I also understand that joggers pushing strollers are solely responsible for the child/children in their care. I am aware that the Veterans Counsel strongly discourages the use of personal audio devices (iPods and MP3 headsets).
In the event I become incapacitated, disoriented, or incapable of making medical decisions and in the absence of a next of Kin, I authorize any healthcare provider to release any and all information to the Veterans Counsel and it staff; pertaining to my healthcare, medical condition and medical treatment as a result of my participation in the Veterans Counselís Dash 4 Dogtags 5K Run/Walk Event.