I desire for myself/my child/children to voluntarily engage in the Laurens United 5K event on Saturday, August 24th, 2019. I understand that this activity may affect the function(s)/system(s)/health of the body during and/or following this event. The effect(s) of the function(s)/system(s)/health of the body during and/or after this event cannot be predicted. I understand that I am responsible for monitoring my own and my child’s/children’s condition throughout this event and should I/we experience any unusual symptom(s)/discomfort(s), I/we will cease participation. I agree to assume the risk of such affect(s)/symption(s)/discomfort(s), and further agree to hold harmless Laurens County School District 55, sponsors, staff members, and those conducting the Laurens United 5K event from any and all claims, suits, losses, and/or related causes of action for damages, including but not limited to, such claims that may result from injury or death, accidental or otherwise, during, and arising from the Laurens United event.
In signing this consent form, I affirm that I have read this from in its entirety and that I understand the nature of the Laurens United 5K event.
I do hereby further declare myself/my child/my children to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my/my child’s/my children’s participation in the Laurens United 5K event.
Participant Signature or Parent/Guardian Signature (if participant is under 18 years of age)_________________________
Printed Name_______________________________________ Date:_________________________