atlanta mission 5k

Client Registration

User Profile

This field is hidden when viewing the form

Contact ID

Name(Required)

First Last

Birthdate(Required)

This field is hidden when viewing the form

Age on Race Day(Required)

Sex(Required)

Phone

Shirt Size

Bib

Did we give them their shirt already?

True

False

Event Waiver

ATLANTA MISSION: ATLANTA, GA RELEASE AND INDEMNITY AGREEMENT For purposes of this Release and Indemnity Agreement, the term “Event Sponsors” means Running Nerds, Atlanta Mission, Pemberton Place – World of Coca-Cola, and event sponsors of all the foregoing and each of their respective agents, officers, directors, owners or shareholders, employees, attendees, volunteers and any other sponsors of, and owners and lessees of premises used to conduct (the “Event”). In consideration of participation in the Event, and for other good and valuable considerations, the receipt and sufficiency of which are herby acknowledged, each of the undersigned participant (the “Participant”) and the Participant’s Parent/Guardian (if signing below). (i) agrees that, prior to participating in the Event, they each will inspect the facilities and equipment to be used, and if either of them believes anything is unsafe, he or she will immediately advise an Event official of such condition(s) and refuse to participate until such condition(s) is corrected; (ii) acknowledges and fully understands that the Participant will be engaging in activities which involve risk of serious injury, including permanent disability and death, that severe social and economic losses might result not only from his or her own actions, inactions or negligence, but also from the actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used, and that there may be other risks not known or not reasonably foreseeable at this time; (iii) assumes all of the foregoing risks and accepts personal responsibility for any damages following any such injury, permanent disability or death and hereby aggress to defend, indemnify and hold the Event Sponsors harmless from and against any liabilities, causes of actions, suits, claims or expenses (including reasonable attorneys’ fees) resulting or arising from the Participant’s presence at or participation in the Event, including, but not limited to, claims for loss of consortium and for emotional distress; (iv) releases, waives, surrenders and discharges any and all claims of damages for death, personal injury or property damage which the Participant, or the Participant’s heirs, next of kin, family members or assigns, may have or which may hereafter accrue to the Participant as a result of his or her participation in the Event or otherwise, and which may be asserted by the Participant, or on the Participant’s or his or her heirs’, next of kin’s, family members’ or assigns’ behalf, against any of the Event Sponsors, INCLUDING, BUT NOT LIMITED TO, ANY AND ALL CLAIMS ARISING OUT OF THE NEGLIGENCE OF ANY OF THE EVENT SPONSORS. (v) acknowledges that no representation or warranty is made by any of the Event Sponsors or any other entity or person regarding any effects of the Participation’s participation in the Event under rules of eligibility of the National Collegiate Athletic Association or any high school federation or association (vi) acknowledges that, if the Participant is under 19 years of age, the parent or authorized guardian of the Participation MUST execute this Release and Indemnity Agreement and the person executing on behalf of the Participation represents and warrants that he or she is the parent or authorized guardian of the Participant; and (vii) grants full irrevocable permission to any and all of the Event Sponsors, with no obligation to compensate the Participant, to use the Participant’s name and likeness, including, but not limited to, the use of the Participant’s name and likeness in any photographs, video tapes, motion pictures, recordings or other record of the Event for all publicity and merchandising purposes, including, but not limited to, use in connection with print and electronic media and publication on the internet, and herby releases and discharges the Event Sponsors from any and all claims, demands or causes of actions for libel, defarnation, invasion or privacy or right of publicity, infringement of copyright or trademark, or violation of any other right arising out of or relating to any utilization of the rights granted hereunder. By checking “I agree with the terms and conditions above.”, the undersigned hereby acknowledge that (A) each of them has read this Release and Indemnity Agreement and understand that each of them has given up substantial rights by signing this document, and (B) each of them is voluntarily executing this Release and Indemnity Agreement. I accept the waiver agreement.

Client Signature(Required)

Legal Consent(Required)

Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures

Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. By signing this document you are agreeing that you have reviewed this Consumer Disclosure and consent and intend to transact business electronically; to use electronic signatures instead of wet ink signatures and paper documents, and to receive notices and disclosures electronically.

You are not required to sign documents electronically or to receive notices and disclosures electronically. If you prefer not to transact business electronically, you may request paper copies from the “sending party” and withdraw your consent at any time, as described below.

Scope of Consent
By utilizing this Service, you agree to receive electronic signature documents with all related and identified documents, notices, and disclosures provided during your relationship with the “sending party.” You may withdraw your consent, at any time, by following the procedures outlined below.

Paper Copies
You are not required to sign documents electronically, or receive notices or disclosures electronically, and may request paper copies of documents or disclosures, if you prefer. You also have the ability to download and print any signed or unsigned documents sent to you through the electronic signature service. We may also email you a copy of all documents you sign using the electronic signature service. If you wish to receive paper copies instead of electronic documents you may close this web browser and request paper copies from the “sending party” by following the procedures outlined below. The “sending party” may apply a charge for additional expenses incurred by printing and mailing paper copies.

Withdrawal of Consent
You may withdraw your consent to receive electronic documents, notices or disclosures at any time. In order to withdraw consent you must notify the “sending party” that you wish to withdraw your consent to transact business electronically and to provide your future documents, notices, and disclosures in paper format. If at any time, after withdrawing your consent you choose to use our electronic signature system your use of this Service will, once again, evidence your consent to receive documents, notices, and disclosures, electronically. You may withdraw your consent to receive electronic notices and disclosures or execute an electronic signature by following the procedures described below.

Withdrawing your consent, requesting a paper copy, or updating your contact information
You always have the ability to download and print any documents sent to you through our electronic signature system. To withdraw your consent to conduct business electronically, sign documents electronically, and receive documents, notices, or disclosures electronically, please contact the “sending party” directly; by telephone, by email (sent to the “sending party” with any of the topics outlined below stated in the subject line of your email) or by postal mail to their mailing address specified to receive such notices.

“Withdrawal of Consent To Transact Business Electronically” To allow the “sending party” to identify and facilitate your withdrawal of consent to transact business electronically, please provide your name, email address, the date on which you are withdrawing your consent, your telephone number and mailing address.

“Requesting A Paper Copy” To allow the “sending party” to identify you to provide a paper copy of the document requiring your signature, the notice, or disclosure, please provide the sending party with your name, email address, mailing address, telephone number, and name of the document of which you are requesting a paper copy .

“Update Your Contact Information” To allow the “sending party” to identify you in order to update your contact information, please provide them with your name, email address, mailing address, and telephone number.

The “sending party” will inform you of any fees related to costs for printing and mailing paper copies or your withdrawal consent to transact business electronically.

I agree to the terms and conditions.