Racing For a Drug-Free Community

THIS ACTIVITY WAIVER FORM (this “Waiver”) dated this ______ day of ___________, ________. IN CONSIDERATION of being allowed to participate in the Activity and other good and valuable consideration,the receipt of which is hereby acknowledged, I __________________________ of ____________________________ (the “Participant”) agree with Wilkes Youth Life Development of PO Box 1112, Moravian Falls, NC 28654 (the “Activity Provider”) to the following: DETAILS OF ACTIVITY Scheduled for April 6th, 2024, the Participant will be participating in the following activity: 5k/10k and Fun Mile (the “Activity’) provided by the Activity Provider. CONSIDERATION Being of lawful age and in consideration of being permitted to participate in the Activity, the Participant released and forever discharges the Activity Provider, its owners, directors, officers, employees, agents, assigns, legal representatives, and successors from all manner of actions, causes of action, debts, accounts, bonds, contracts, claims and demands for or by reason of any injury to person or property, including injury resulting in death of the Participant, which has been or may be sustained as a consequence of the Participant’s participation in the Activity, and notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Activity Provider. The Participant understands that the Participant would not be permitted to participate in the Activity unless the Participant signed this Waiver. CONCURRENT RELEASE The Participant acknowledges that this Waiver is given with the express intention of effecting the extinguishment of certain obligations owed to the Participant by Activity Provider, and with the intention of binding the Participant’s spouse, heirs, executors, administrators, legal representatives, and assigns. FITNESS TO PARTICIPATE The Participant acknowledges to the Activity Provider that the Participant does not have any physical limitations, medical ailments, or physical or mental disabilities that would limit or prevent the Participant from participating in the Activity. If required, the Participant will obtain a medical examination and clearance. FULL AND FINAL SETTLEMENT The Participant acknowledges and agrees with the Activity Provider that: (1) the Activity Provider has given the Participant sufficient time to carefully read and understand this Waiver, (2) the Participant has been given the opportunity and has been encouraged to seek independent legal advice prior to signing this Waiver, (3) the Participant fully understands the risks and claims that the Participant is waiving to participate in the Activity, (4) the Participant is freely and voluntarily executing this Waiver, and (5) the Participant is forever prevented from suing or otherwise claiming against the Activity Provider for any property damage or loss, personal injury that the Participant may sustain while participating in or preparing for the Activity. GOVERNING LAW This Waiver will be governed by and construed in accordance with the laws of the State of North Carolina.