First Name *

Last Name *

Email *

First Name *

Last Name *

Email *

First Name *

Last Name *

Email *

First Name *

Last Name *

Email *

First Name *

Last Name *

Email *

Waiver and Release of Liability
For faculty/staff, 18 years of age and older.

I fully recognize that there are dangers and risks to which I may be exposed to by participating in Race with GVPD during the GVSU Wellness Summit, an activity sponsored by the Grand Valley State University Division of People, Equity, and Culture, and the Department of Public Safety. I understand the University cannot guarantee my personal safety while I am participating in this event. There are dangers and risks associated with any activity including the risk of physical injury. These risks include, but are not limited to, slips, trips, falls, collisions with participants, spectators, vehicles, or objects; uneven pavement; adverse weather conditions; heat- or cold-related illness; dehydration; overexertion; muscle strains, sprains, fractures, cardiovascular events, allergic reactions, and other injuries that may result in permanent disability or death. Participation in the activity is completely voluntary.

I certify that I am physically capable of participating and have consulted with a physician if I have any concerns regarding my fitness to participate. I voluntarily assume all known and unknown risks associated with participation, travel to and from the event, and any related activities.

I agree to follow the behavior guidelines outlined in University Policy, all event rules, instructions, and directions provided by University employees, volunteers, law enforcement personnel, and race officials; conduct myself in a safe and responsible manner; immediately discontinue participation if I believe I cannot safely continue; and report hazardous conditions to event personnel. If I do not comply with those conditions, or any of the responsibilities outlined above, I understand this may result in dismissal from the activity/event. 

If I am injured or become ill while traveling or participating in the activity, I give my permission to employees of Grand Valley State University to seek medical treatment for me during times when they are leading the Race with GVPD. I understand that this authorization is given in advance of any specific diagnosis, or treatment or medical care being required and is to serve as specific consent to any and all such diagnosis, treatment or hospital care which may be deemed advisable. I understand and agree that employees of Grand Valley State University assume no responsibility for any injury or damage which might arise out of or in connection with such authorized emergency medical treatment and I indemnify them for any expenses related to my medical diagnosis, treatment or care.

Release
In consideration for being permitted to participate, I, on behalf of myself, my heirs, personal representatives, executors, administrators, successors, and assigns, hereby release, waive, discharge, and covenant not to sue Grand Valley State University, their officers, employees, agents, volunteers, representatives, sponsors, successors, and assigns from any and all liability, claims, demands, actions, damages, losses, costs, or expenses arising out of or relating to any injury, illness, death, or property damage sustained as a result of my participation, whether caused by negligence or otherwise, to the fullest extent permitted by Michigan law. Nothing in this waiver is intended to waive liability that cannot legally be waived under applicable law. 

I certify that I have carefully read this agreement, fully understand its contents, and sign it freely and voluntarily. 

Are any of your registered guest(s) under the age of 18? *
- Select Option Yes No

Waiver and Release of Liability
For guests, including minors (under the age of 18).

I fully recognize that there are dangers and risks to which my guest(s) may be exposed to by participating in Race with GVPD during the GVSU Wellness Summit, an activity sponsored by the Grand Valley State University Division of People, Equity, and Culture, and the Department of Public Safety. I understand the University cannot guarantee my guest(s) safety while I am participating in this event. There are dangers and risks associated with any activity including the risk of physical injury. These risks include, but are not limited to, slips, trips, falls, collisions with participants, spectators, vehicles, or objects; uneven pavement; adverse weather conditions; heat- or cold-related illness; dehydration; overexertion; muscle strains, sprains, fractures, cardiovascular events, allergic reactions, and other injuries that may result in permanent disability or death. Participation in the activity is completely voluntary.

I certify that my guest(s) is physically capable of participating and have consulted with a physician if I have any concerns regarding their fitness to participate. I voluntarily assume all known and unknown risks associated with participation, travel to and from the event, and any related activities.

I agree that myself and my guest(s) will follow the behavior guidelines outlined in University Policy, all event rules, instructions, and directions provided by University employees, volunteers, law enforcement personnel, and race officials; conduct ourselves in a safe and responsible manner; immediately discontinue participation if I believe I/my guest(s) cannot safely continue; and report hazardous conditions to event personnel. If my guest(s) do not comply with those conditions, or any of the responsibilities outlined above, I understand this may result in dismissal from the activity/event. 

If my guest(s) is injured or becomes ill while traveling or participating in the activity, I give my permission to employees of Grand Valley State University to seek medical treatment for them during times when they are leading the Race with GVPD. I understand that this authorization is given in advance of any specific diagnosis, or treatment or medical care being required and is to serve as specific consent to any and all such diagnosis, treatment or hospital care which may be deemed advisable. I understand and agree that employees of Grand Valley State University assume no responsibility for any injury or damage which might arise out of or in connection with such authorized emergency medical treatment and I indemnify them for any expenses related to my guest(s) medical diagnosis, treatment or care.

Release
In consideration for being permitted to participate, I, on behalf of myself and my guest(s), my heirs, personal representatives, executors, administrators, successors, and assigns, hereby release, waive, discharge, and covenant not to sue Grand Valley State University, their officers, employees, agents, volunteers, representatives, sponsors, successors, and assigns from any and all liability, claims, demands, actions, damages, losses, costs, or expenses arising out of or relating to any injury, illness, death, or property damage sustained as a result of my participation, whether caused by negligence or otherwise, to the fullest extent permitted by Michigan law. Nothing in this waiver is intended to waive liability that cannot legally be waived under applicable law. 

I certify that I have carefully read this agreement on behalf of my guest(s) (including minors), fully understand its contents, and sign it freely and voluntarily.