2015 Chesapeake Headwaters 12-hour AR  -  Online USARA Waiver/Membership


To complete our online USARA Waiver for the 2015 Chesapeake Headwaters 12-hour AR, please
read the following carefully and fully:




WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT (Specific Event Waiver)

Event Name: 2015 Chesapeake Headwaters 12-hour Adventure Race
Event Date(s): August 29, 2015

IN CONSIDERATION of the United States Adventure Racing Association (“USARA”) allowing me to participate in the USARA sanctioned event
described above (the “Event”) as either a member of USARA or through the issuance of a single event license; I, for myself, and on behalf of my spouse,
children, parents, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns, hereby
agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity
Agreement (the “Agreement”);

1. I hereby represent that (i) I am in good health and in proper physical condition to participate in the Event; and (ii) I am not under the influence of
alcohol or any illicit or prescription drugs which would in any way impair my ability to safely participate in the Event. I agree that it is my sole
responsibility to determine whether I am sufficiently fit and healthy enough to participate in the Event.

2. I understand and acknowledge the physical and mental rigors associated with this adventure racing Event, and realize that many elements of this Event
are inherently dangerous and represent an extreme test of a person’s physical and mental limits. I understand that participation involves risks and dangers
which include, without limitation, the potential for serious bodily injury, permanent disability, paralysis and death; loss or damage to property; exposure to
extreme conditions and circumstances; contact or collision with other participants, spectators, vehicles or other natural or manmade objects; dangers
arising from adverse weather conditions; imperfect course conditions; water, road and surface hazards; equipment failure; inadequate safety measures;
participants of varying skill levels; situations beyond the immediate control of the Event Organizers; and other undefined, not readily foreseeable and
presently unknown risks and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by my own actions or inactions, the
actions or inactions of others participating in the Event, or the negligence of the Released Parties defined below, and I hereby expressly assume all such
Risks and responsibility for any damages, liabilities, losses or expenses which I incur as a result of my participation in the Event.

3. I agree to be familiar with and abide by the Rules and Regulations established for the Event, including but not limited to rules and regulations related to
the Competition, Safety, and the USARA Adventure Racer Code of Ethics. I also accept sole responsibility for my own conduct and actions while
participating in the Event, and the condition and adequacy of my equipment.

4. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: USARA, the
Event Organizers and Promoters, Race Directors, Sponsors, Advertisers, Host Cities, Local Organizing Committees, Venues and Property Owners
upon which the Event takes place, Law Enforcement Agencies and other Public Entities providing support for the Event, and each of their respective
parent, subsidiary and affiliated companies, officers, directors, partners, shareholders, members, agents, employees and volunteers (Individually and
Collectively, the “Released Parties” or “Event Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or
expense (including court costs and reasonable attorneys fees) of any kind or nature (“Liability”) which may arise out of, result from, or relate to my
participation in the Event, including claims for Liability caused in whole or in part by the negligence of the Released Parties. I further agree that if, despite
this Agreement, I, or anyone on my behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless
each of the Released Parties from any such Liabilities which any may be incurred as the result of such claim.

5. I hereby pre-authorize the Event Organizers and their representatives to arrange for emergency medical treatment and/or transport via ambulance or
air on my behalf if medical attention is warranted during my participation in the Event. I understand and agree that I will be responsible for the costs
associated with any such emergency medical care and/or transport arranged on my behalf, and hereby release the Event Organizers from any Liability
relating to the cost and provision of any rescue operations, first aid treatment, medical care, hospital expenses or the medical decisions made at the Event
site or elsewhere on my behalf .

I hereby warrant that I have read this Agreement carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal
rights by signing it (including the rights of the minor, my spouse, children, parents, guardians, heirs and next of kin, and any legal and personal
representatives, executors, administrators, successors and assigns), and intend for my signature to serve as confirmation of my complete and
unconditional acceptance of the terms, conditions and provisions of this Agreement. This Agreement represents the complete understanding between the
parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this
Agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and shall not
affect the validity and enforceability of any remaining provisions.
Full Name: (typing of name denotes electronic signature)
Address:
City:
State:
Zip Code:
Phone Number:
E-mail Address:
Date of Birth:
Today's Date (MM/DD/YYYY):
I have read this Agreement carefully.
I understand its terms and conditions.
USARA MEMBERSHIP - (Complete ONE of the following 3 options)
I have a current USARA membership - Membership Number:
Expiration Date:
1 Year USARA Membership - $35.00 cash due at pre-race meeting
Single Event USARA License - $8.00 cash due at pre-race meeting