2003 ACKNOWLEDGMENT
WAIVER & RELEASE FROM LIABILITY FORM (AWRLF) FOR THE
ACCENTURE CHICAGO TRIATHLON (ACT),
THE FLEET FEET SUPERSPRINT AND
McDONALD’S® KIDS TRIATHLON (KIDS)
Read
this form carefully, complete, sign & submit at race packet pick
up. If under 18 years in age, the signature of your Parent or Guardian
is also required. If you fail to complete, sign & submit this form,
you will be prohibited from participating in the event (no refunds).
I certify that I have carefully read all the information contained in
the Event Confirmation Brochure, understood the information, attended
a course talk if I had any concerns or questions regarding any aspect
of the Event and had those questions satisfactorily answered. I further
certify that as the participant, I am physically fit & have sufficiently
trained to participate in the ACT , SuperSprint or my child is physically
fit & has sufficiently trained to participate in the ACT, SuperSprint
or KIDS, & as a participant, my physical condition for participation
or my child’s physical condition for his or her participation
has been verified by a qualified licensed medical Doctor (MD). I also
certify that the equipment I or my child will be using in the ACT, SuperSprint
or KIDS including but not limited to a wetsuit, bike helmet, bicycle,
cycling shoes, running shoes, etc., fit properly, have been verified
by a qualified professional to be in good working order, & meet
the standards as defined in this brochure under Rules of Participation/Race
Day Procedures. I acknowledge that the event (ACT, SuperSprint &
KIDS) will be an extreme test of my or my child’s physical &
mental ability & carries the potential for death, serious injury,
& property loss. Risks include, but are not limited to those caused
by terrain; road surface; temperature; water conditions; weather; vehicular
traffic; actions of others; & lack of hydration. I am aware that
the support personnel who will provide emergency first aid will be volunteers.
I hereby consent to receive medical treatment for myself or my child
which may be deemed advisable in the event of injury, accident or illness
during the event(s). I hereby take action for myself, my executors,
administrators, heirs, next of kin, successor & assigns as follows:
A. WAIVE, RELEASE & DISCHARGE from any & all
liability for myself or my child, for my or my child’s death,
disability, personal injury, property damage, property theft or actions
of any kind which may hereafter accrue to me or my child as a result
of my or my child’s participation in the ACT, SuperSprint or KIDS.
THE FOLLOWING PERSONS OR ENTITIES: Creative & Production Resources,
Inc. (CAPRI) the Event producer, the Accenture Chicago Triathlon, The
Fleet Feet Sports SuperSprint & McDonald’s Kids Triathlon,
all Event sponsors, race directors, race staff, race volunteers, the
City of Chicago, the Chicago Park District, Cook County, the State of
Illinois, & its (their) office, officers, directors, employees,
representatives & agents & volunteers.
B. INDEMNIFY & HOLD HARMLESS the persons or entities
mentioned in this paragraph from any & all liabilities & expenses
(including reasonable attorneys’ fees) or claims made by other
individuals or entities as a result of any of my or my child’s
actions during the ACT, SuperSprint or KIDS. I understand that during
the Triathlon I or my child may be photographed & I agree to allow
my or my child’s photo, video, name or likeness to be used for
any legitimate purpose by CAPRI, Accenture., event sponsors &/or
assigns. This form shall be construed broadly to provide a release &
waiver to the maximum document; & I understand its contents. I am
aware that the Event (Accenture Chicago Triathlon, The Fleet Feet Sports
SuperSprint and the McDonald’s Kids Triathlon) is an advertising/marketing
vehicle for Events Sponsors (SPONSORS) and that SPONSORS merely provide
trade (product and/or services) and/or financial support. I am also
aware that SPONSORS have no part in, or responsibility for, planning,
conducting or administering any aspect of the Event or for the well
being, health or safety of Event participants. I hereby agree that in
the event of race cancellation due to weather conditions. “acts
of God”, or any other reason, my or my child’s registration
fee shall not be refunded.
Date ________ Signature__________________________________
Signature of Parent or Guardian if under 18 years of age:
Signature___________________________________
|
|
2003 SWIM
WAIVER FORM (SWF) FOR THE ACCENTURE CHICAGO TRIATHLON
(ACT) (SPRINT & INTERNATIONAL DISTANCE)
Date ___________
Signature ________________________________
Signature of Parent or Guardian if under 18 years of age:
Signature _________________________________________
To participate in the swim leg of the ACT (Event), you must be capable
of safely swimming a half-mile in open water for the Sprint Distance
competition or a mile in open water for the International Distance competition,
and must meet at least one of the following requirements:
a) You have participated on an age-group, high school
or college swim team.
b) You have completed the swim in a triathlon of equal
or greater distance.
c) You have completed a continuous swim in a pool or
in open water of equal or greater distance within the last 30-days.
You must read, understand and complete the SWF prior to registration.
Sign & submit the SWF at race packet pick up. Do not mail.
If under 18 years, the signature of your Parent or Guardian is also
required. If you fail to complete, sign & submit the SWF, you will
be prohibited from participating in the ACT (no refunds).
COMPLETE THE FOLLOWING:
1. I have completed the swim leg of a triathlon of
equal or greater distance.
Name of event ________________ Location ______________
Distance _____________ Swim Time __________ Date ______
2. I have competed on an age-group, high school or
college swim team.
School ____________________________ Years ___________
3. I have successfully completed a continuous 1/2-mile
swim (for Sprint Distance event) or 1-mile swim (for International Distance
event within the last 30-days.
Location _________________ Distance _______ Date _______
I hereby certify that the above information is true. I also acknowledge
that the swim portion of the ACT will be an extreme test of my abilities
& carries the potential for death or injury. Risks include, but
are not limited to those caused by obstacles; contact with watercraft
&/or swimmers; water conditions; weather & actions of others.
I am aware that those (Chicago Park District life guards & Event
medical team) who will provide emergency first aid will be volunteers.
I hereby consent to receive any medical treatment that may be deemed
advisable in the event of injury, accident or illness during the Event.
I hereby take action for myself, my executors, administrators, heirs,
next of kin, successor & assigns as follows:
A. WAIVE, RELEASE & DISCHARGE from any & all
liability for my death, disability, personal injury or actions of any
kind which may hereafter accrue to me as a result of my participation
in the ACCENTURE CHICAGO TRIATHLON THE FOLLOWING PERSONS OR ENTITIES:
Creative & Production Resources, Inc. (CAPRI) the Event producer,
Chicago Triathon (the Events), D.L. Zimco, Inc. (dba Fleet Feet Sports),
LincWilson, Inc. (dba Fleet Feet Sports), Ironman Wetsuits, Inc., the
Chicago Triathlon & Multisport Club and their membership, all Event
sponsors, Event management/ staff/volunteers, City of Chicago, the Chicago
Park District, Cook County, the State of Illinois & its (their)
office, officers, directors, employees, representatives & agents
& volunteers.
B. INDEMNIFY & HOLD HARMLESS the persons or entities
mentioned in this paragraph from any & all liabilities & expenses
(including reasonable attorneys’ fees) or claims made by other
individuals or entities as a result of my actions during the MRS. T’S
CHICAGO TRIATHLON. This form shall be construed broadly to provide a
release & waiver to the maximum document; & I understand its
contents.
Date ___________ Signature _______________________________
Signature of Parent or Guardian if under 18 years of age:
Signature ___________________________________
|