Health and Wellness Ministry

Fundraiser Run/Walk 3K

Date: Saturday, May 11, 2024, 10 am

Where: Start from Regency Stadium

Fee: $5

To register, please fill out the form below.

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Emergency Contact Name

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Health and Wellness Ministry Liability Waiver / Informed Consent Form “I am participating in the Health and Wellness Ministry Walk/Run 3K held by New Hope Church of God Waldorf, under the direction of the Health and Wellness Ministry. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this event. I acknowledge that my participation is purely voluntary and in no way mandated by the Health and Wellness Ministry. In consideration of my participation in this event, I, hereby release New Hope Church of God Waldorf and the Health and Wellness Ministry from any claims, demands, and causes of action as a result of my voluntary participation. I hereby release New Hope Church of God Waldorf and the Health and Wellness Ministry from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I may incur, including death.” I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS.

By checking the option below, I have read and agree to the Health and Wellness Ministry Liability Waiver / Informed Consent Form.

You are unable to register if you do not agree to the terms above

Yes, I agree to the terms above.

Signature

This is used as your signature to the Health and Wellness Ministry Liability Waiver / Informed Consent Form

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Date Signed

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