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First & Last Name:

Email address:

State where you want to run:

Between which hours do you *estimate* you will show
up?

AGREEMENT:

I, FOR MYSELF OR FOR ANY INDIVIDUAL FOR WHICH I ACCEPT
RESPONSIBILITY FOR AGREE TO THE FOLLOWING: I AM NOT RUNNING
IN ANY EVENT AFFILIATED WITH LISA SMITH BATCHEN, OR ANY
OF THE FOLLOWING ENTITIES: DREAMCHASERS FOUNDATION; ORPHAN
FOUNDATION OF AMERICA; RELIGIOUS TEACHERS FILIPINI; CARING
HOUSE PROJECT; DREAMCHASER EVENTS OR ANY AND ALL SPONSORS
OR THEIR REPRESENTATIVES (HERETOFORE REFERRED TO AS “AFFILIATES”)

NONE OF THE ABOVEMENTIONED AFFILIATES WILL BE RESPONSIBLE
FOR PROVIDING ANY SORT OF AID, INCLUDING MEDICAL, NUTRITIONAL,
LOGISTICAL OR OTHERWISE.

NONE OF THE ABOVEMENTIONED AFFILIATES ARE SPONSORING, ENDORSING
OR OTHERWISE ENTERING INTO ANY UNDOCUMENTED, ORAL OR OTHERWISE
ASSUMED AGREEMENT WITH THE BELOW SIGNED.

NONE OF THE ABOVEMENTIONED AFFILIATES ARE RESPONSIBLE FOR
ANY INJURIES OR DAMAGE SUSTAINED BY THE BELOW SIGNED AT
THE PRESENT TIME OR ANY TIME IN THE FUTURE.

I, FOR MYSELF OR FOR ANY INDIVIDUAL FOR WHICH I ACCEPT
RESPONSIBILITY, AND ANYONE ENTITLED TO ACT ON MY BEHALF,
WAIVE AND RELEASE THE ORGANIZERS RUNNING HOPE THROUGH AMERICA
AND ITS AFFILIATES AND ALL SPONSORS OR THEIR REPRESENTATIVES
AND SUCCESSORS FROM ALL CLAIMS OR LIABILITIES OF ANY KIND
ARISING OUT OF RUNNING WITHIN 50 FEET OF LISA SMITH BATCHEN
AT ANY TIME.

I, FOR MYSELF OR FOR ANY INDIVIDUAL FOR WHICH I ACCEPT
RESPONSIBILITY, FULLY UNDERSTAND THAT RUNNING HOPE THROUGH
AMERICA, ITS ORGANIZERS, LISA SMITH BATCHEN NOR THE ABOVE
MENTIONED AFFILIATES WILL BE PROVIDING ANY RUNNING ASSISTANCE,
AID STATIONS, MEDICAL ASSISTANCE, HYDRATION FACILITIES,
WATER, NUTRITION OR OTHER FACILITIES OR EQUIPMENT NECESSARY
FOR RUNNING SAFELY. FURTHER, I AGREE THAT I WILL PROVIDE
MY OWN EQUIPMENT NECESSARY FOR RUNNING/WALKING SAFELY.

I, FOR MYSELF OR FOR ANY INDIVIDUAL FOR WHICH I ACCEPT
RESPONSIBILITY, FULLY UNDERSTAND THAT RUNNING HOPE THROUGH
AMERICA, ITS ORGANIZERS, LISA SMITH BATCHEN NOR THE ABOVE
MENTIONED AFFILIATES WILL BE RESPONSIBLE FOR PROVIDING SERVICES
OR FACILITIES OF ANY RUNNER/WALKER WITH ANY DISABILITY,
PHYSICALLY OR MENTALLY.

I GRANT PERMISSION TO ALL OF THE FOREGOING TO USE ANY PHOTOGRAPHS,
MOTION PICTURES, RECORDINGS, OR ANY OTHER RECORD OF THIS
EVENT FOR LEGITIMATE PURPOSES.

BY CHECKING THIS BOX, YOU INDICATE THAT YOU AGREE TO THE ABOVE
STATEMENTS

Anything else we should know? Any comments?