In consideration of your acceptance of
this entry, I hereby, for myself, my executors and
administrators, waive any and all rights and claims for
damages I may have against the sponsors, coordinating
groups, and any individuals associated with the event,
their representatives, successors and assigns, and will
hold them harmless for any and all injuries suffered in
connection with said event. Also, none of the
above are responsible for the loss of personal items nor
any other form of aggravation in connection with the
said event. I have been warned I must be in good
health to participate in this event. I also
give permission for the free use of my name and picture
in any broadcast, telecast or print media account of
this event. In filling out this form. I
acknowledge I have read and fully understand my own
liability and do accept restrictions. NO REFUNDS!