Piedmont 8 Hour

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Team name   First name   Last name   Email address   Age on event date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 Gender -- Male Female Female/Male   Phone #   Emergency contact name   Emergency phone #   City   State / Province   Category Choose one 2 Person Relay Solo   Event entry fee TBD

T-shirt size None Small Medium Large Extra large Vegetarian? Military/First Responder/Law Enforcement? If so, enter "military" for discount code and a discount of $5 How did you hear about the race?

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Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver I UNDERSTAND THAT PARTICIPATION IN THE PIEDMONT 8-HOUR RUN IN ANY FORM IS POTENTIALLY HAZARDOUS. I SHOULD NOT PARTICIPATE WITHOUT BEING MEDICALLY ABLE AND PROPERLY TRAINED. BY SIGNING THIS FORM I AM VOUCHING THAT I AM MEDICALLY ABLE AND PROPERLY TRAINED. I UNDERSTAND THE EVENT IS HELD IN A REMOTE WILDERNESS AREA WHERE EMERGENCY ACCESS MAY NOT ALWAYS BE AVAILABLE AND IF AVAILABLE IT COULD TAKE SIGNIFICANT TIME FOR MEDICAL PERSONNEL TO REACH ME, AND EVEN LONGER TO BE EVACUATED. EXPOSURE TO EXTREME COLD WEATHER, WIND, STORMS, LIGHTNING AND OTHER EXTREME DANGERS ARE POSSIBLE. THERE ARE MANY KNOWN AND UNKNOWN SEVERE DANGERS WHICH MAY RESULT IN VERY SERIOUS INJURY, SICKNESS AND DEATH. I UNDERSTAND PARTICIPATION CARRIES WITH IT CERTAIN INHERENT RISKS THAT CANNOT BE ELIMINATED RANGING FROM MINOR INJURIES TO CATASTROPHIC INJURIES INCLUDING DEATH. I UNDERSTAND AND AGREE IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE EVENT THAT ME AND ANY PARTICIPANT, THEIR HEIRS, PERSONAL REPRESENTATIVES OR ASSIGNS DO HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE VIRGINIA ADVENTURES LLC, ANY OF ITS OWNERS, OFFICERS, RACE DIRECTORS, REPRESENTATIVES, EVENT VOLUNTEERS, ALL CITIES, MUNICIPALITIES, COUNTIES AND THEIR REPRESENTATIVES, THE STATE OF VIRGINIA, POWHATAN STATE PARK, USA TRACK & FIELD AND THE UNITED STATES OF AMERICA FROM ANY AND ALL LIABILITY FROM ANY AND ALL CLAIMS ARISING FROM PARTICIPATION BY ME OR ANY REGISTERED PARTY. BY INDICATING MY ELECTRONIC ACCEPTANCE OF THIS WAIVER I AM AFFIRMING THAT I HAVE READ AND UNDERSTAND THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. I ACKNOWLEDGE THAT I AM ELECTRONICALLY SIGNING THE AGREEMENT FREELY AND VOLUNTARILY, AND INTEND BY MY ACCEPTANCE FOR IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. I UNDERSTAND ELECTRONIC SIGNATURES CARRY THE SAME BINDINGS AS HAND SIGNED SIGNATURES. I ACCEPT ALL INHERENT RISKS AND DANGERS WHICH MAY OR MAY NOT BE READILY FORESEEABLE, INCLUDING WITHOUT LIMITATION PERSONAL INJURY, PROPERTY DAMAGE OR DEATH THAT MAY ARISE FROM PARTICIPATION IN ANY FORM IN THE PIEDMONT 8-HOUR RUN. I ACCEPT THE TERMS OF THIS WAIVER. I accept the terms of the waiver Name of parent or guardian who approves this activity Please enter your name here