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Chanco on the James 5K Adventure Run

Surry County, VA 23881

Registrant #1

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Open to ages 1 - 98.

$35.00 + $3.10 SignUp Fee

Open to ages 1 - 98.

$35.00 + $3.10 SignUp Fee

Open to ages 1 - 98.

$35.00 + $3.10 SignUp Fee


Waiver

In consideration of you accepting this entry, I, the participant, intending to be legally bound do hereby waive and forever release any and all rights and claims for damages or injuries that I may have against the Event Director, RunSignup.com, and all of their agents assisting with the event, sponsors and their representatives, volunteers and employees for any and all injuries to me or my personal property. This release includes all injuries and/or damages suffered by me before, during or after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.

I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able to do so and properly trained. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, traffic, and course conditions, and waive any and all claims which I might have based on any of those and other risks typically found in running a road race. I acknowledge all such risks are known and understood by me. I agree to abide by all decisions of any race official relative to my ability to safely complete the run. I certify as a material condition to my being permitted to enter this race that I am physically fit and sufficiently trained for the completion of this event and that a licensed Medical Doctor has verified my physical condition.

In the event of an illness, injury or medical emergency arising during the event I hereby authorize and give my consent to the Event Director to secure from any accredited hospital, clinic and/ or physician any treatment deemed necessary for my immediate care. I agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medications, treatment and hospitalization.

As it applies to my participation in this race, I agree to abide by the Center for Disease Control (CDC)’s recommendations for the prevention of the spread of COVID-19 and attest to having read the CDC’s guidance at: https://www.cdc.gov. I also agree to abide by any COVID-19 distancing and other safety guidelines issued by the state, the community or by this race for my participation in this race.

Further, I grant permission to all the foregoing to use my name, voice and images of myself in any photographs, motion pictures, results, publications or any other print, videographic or electronic recording of this event for legitimate purposes.

This event follows the standard running industry policy: All entry fees are non-refundable. We reserve the right to postpone or cancel the event due to circumstances beyond our control such as a natural disaster or emergency or as required to protect the safety of participants and staff. No refunds will be issued under these circumstances. We reserve the right to change the details of the event without prior notice. I understand that my entry fee is nonrefundable and bib numbers are non transferable.

By submitting this entry, I acknowledge (or a parent or adult guardian for all children under 18 years) having read and agreed to the above release and waiver including the no refund policy.


Waiver

CHANCO RELEASE

In consideration of being allowed to participate in activities for education/recreational purposes sponsored through Chanco on the James, Surry County, Virginia, which activities will or may include, without limitation, ropes course participation, zip lining, canoeing, kayaking, sailing, swimming, biking, hiking, archery, and service projects (hereinafter “Activities”), I agree that I understand the nature of these Activities and that I am in good health and in proper physical condition to participate in these Activities.  I agree to participate only while wearing the protective equipment required and to follow the instructions of the counselors and facilitators, and, if I believe it unsafe, to immediately discontinue my participation.  I know that these Activities involve risk of serious bodily injury, including disability, and death, and damage or loss of personal property, and other known and foreseeable risks including, but not limited to, the risks of travel on roads or rough terrain by foot, conveyances, or other means, and on water; the risks arising from the failure or misuse of equipment; and the risks that injuries may occur in remote areas without adequate medical facilities.  I realize that there may be other risks not known to me or not readily foreseeable, but I fully accept and assume all such risks, whether or not identified above, and I assume all responsibility for losses and damages which I may suffer as a result of my participation in these Activities.

I HEREBY RELEASE Chanco on the James/Episcopal Diocese of Southern Virginia, its members, representatives, officers, agents, employees, and each of them, and the owners and lessors of the property on which these Activities take place (hereinafter “Released Parties”), from all liability, claims, demands, losses, costs and damages arising or asserted to arise, directly or indirectly, in whole or in part, from these Activities, whether resulting from negligence or otherwise and including rescue operations and will indemnify and hold harmless the Released Parties as to all such matters. 
I have read the foregoing Release, Assumption of Risk and Indemnity Agreement.  I understand that I will give up substantial rights by signing it.  I have signed it freely and without any inducement or assurance of any nature not stated herein.  I intend it to be a complete and unconditional release, assumption of risk and indemnity to the greatest extent allowed by law; and agree that if any portion of this Agreement is held invalid, the remainder shall continue in full force and effect.
ADULT CONSENT AND ASSUMPTION OF RESPONSIBILITY 
(Parent Signature Required for Participants under the age of 18)
I understand the nature of the above Activities, am familiar with the Participant’s experience and capabilities, and believe him/her to be qualified to participate. I hereby personally accept and undertake, individually and in my own name, all of the obligations stated above, specifically including the release, assumption of risk, and hold harmless provisions as to the Released Parties of all liability, claims, demands, losses and damages suffered or alleged to have been suffered or incurred by the minor or to others resulting from injury to the minor.

PHOTO/VIDEO RELEASE
I, as a participant or parent/guardian of a participant, grant permission for the videotaping and/or photographing of myself and/or the participant. I further give permission and consent that any such photographs may be published and used by Chanco on the James and The Episcopal Diocese of Southern Virginia, to illustrate and promote Chanco on the James and its programs




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