Winter Speed & Conditioning Registration
Indicates required field
Athlete's Date of Birth (mm/dd/yyyy)
USATF Membership Number *All team members MUST have an active USATF membership.
All WaxhawTC members must also be members of USA Track & Field. USATF memberships can be obtained at usatf.org. When registering, make sure to enter Waxhaw Track Club's number: 980
Adult Extra Large
Parent or Legal Guardian's Name
Parent/Guardian Phone #
Emergency Contact Name
Emergency Phone #
Please List Any Allergies or Health Concerns
WaxhawTC Inc. Accident Waiver and Release of Liability Form
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
•I certify that I am physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional.
•I certify that there are no health-related reasons or problems, which preclude my participation in this activity or event.
•I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event.
•In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from team events.
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the Waxhaw Track Club or it’s coaches and volunteers from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. I acknowledge that participation on this team or club may involve a test of a person’s physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to participants, but are also present for volunteers. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event.
•I understand that at practices, events, or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the WaxhawTC Inc. event organizers, and assigns.
The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
Accident Waiver and Release of Liability
I acknowledge that I have read, understand, and fully accept the WaxhawTC Inc. Accident Waiver and Release of Liability.
Accident Waiver and Release of Liability Signature
Registration is not complete until form is submitted and
payment made through the team store.
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