The Madison County Public Library’s Couch to 5k Team Adult Participation Agreement and Release of Liability:
I understand that there are inherent risks involved in participating in physical activity and that I will assume all risks and hazards incidental to such participation as hereinafter stated:
In consideration of being allowed to participate in the Madison County Public Library’s Couch to 5k Program, I do hereby forever waive, release, and discharge Madison county Public Library, its employees and agents from any and all claims or liabilities for injuries or damages to my person and or property including those caused by the negligent act or omission arising out of or connected with my participation in the activities related to the Couch to 5k Programs
I hereby express and affirmatively state that I wish to participate in the Couch to 5k Program provided by the Madison County Public Library. I realize that my participation in this activity involves risk of injury including but not limited to bodily injuries, heart attack, stroke, and even death. I also recognize that there are many other risks of injury, including serious disabling injuries, which may arise due to my participation in this activity and that it is not possible to list each and every individual injury risk. I do hereby further declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation in this program. I do hereby acknowledge that I have been informed of the need for a physician’s approval for my participation in the exercise activities programs. I also acknowledge that it has been recommended that I have yearly or more frequent physical examinations and consultations with my physician as to physical activity and exercise. I acknowledge that I have either had a physical examination and have been given my physician’s permission to participate, or that I have decided to participate in the exercise activities without the approval of my physician and do hereby assume all responsibility for my participation in said activities. Knowing, understanding and appreciating risks and reasonably anticipating that other injuries or even death are a possibility, I hereby expressly assume all risks of injury, which could occur by reason of my participation in this running program.
Parent/Guardian must sign if under 18
