Register for the 2019 Devotion to Children Mother's Day 4 Miler



Proudly benefitting Devotion to Children

Sunday May 12 at Browns Chapel, Reston

The 4 Miler will start and finish at Browns Chapel Park, just off of Baron Cameron Ave, in beautiful Reston, Virginia. There will also be a 1 mile fun run/walk available on the grounds of the park. Food and awards will follow the race.

Packet Pick up will be held at the Reston PR Store on Saturday, May 11 from 11:00-3:00 and again on site race day morning starting at 6:45 am. 

 

Category

Waiver

I know that running can be a hazardous activity and that I should not enter and run unless I am medically able and properly trained. I assume all risks associated with running, including, but not limited to, falls, weather conditions including high heat and/or humidity, contact with other participants, the effects of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, I for myself and anyone entitled to act on my behalf, waive and release Potomac River Running, Inc., Potomac River Running Charitable and Educational Events Inc., Commonwealth Race Management, Inc., and all event partners, sponsors and volunteers, their representatives and successors from all claims or liability of any kind arising out of my participation in this race even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, or other record of this event for any legitimate purpose without compensation to me. For safety reasons, I agree not to officiate with any of the following: Wheelchairs, strollers, baby joggers, skates, pets or headsets. I understand that there are no refunds should severe weather cancel the event. I further understand that this event may change date or location if required by local authorities. I agree that my email address will be added to the Potomac River Running, Devotion to Children, and the Commonwealth Race Management email list. RESTON ASSOCIATION WAIVER Athletic Event on Reston Facilities I hereby voluntarily register for the (name of event) to be held on __________________. I understand and acknowledge that the (name of event) (“Activity”) is sponsored and promoted by (sponsoring organization) and sanctioned by (sanctioning body – if applicable). I hereby assume all risk and agree to accept full responsibility and liability for any damages or bodily injuries I or any of my dependents may cause, sustain, or suffer arising out of participation in the above-referenced Activity, including any such damages or bodily injuries occurring during, resulting from, or related to any travel to or from the Activity. I hereby agree to be fully liable for and I hereby agree to waive and release on behalf of myself and my heirs, successors and assigns, the Reston Association, its Board of Directors, officers, employees, agents, volunteers, and members from any and all injuries, bodily injuries, costs, damages, causes of action, claims and any consequential and incidental damages arising out of or resulting from any injury, death, or damage to property which I or my dependent may sustain, suffer, or cause as a result of my participation in the above-referenced Activity, including any such injuries, costs, damages, causes of action, claims and any consequential and incidental damages occurring during, resulting from, or related to any travel to or from the Activity. I further agree to indemnify, reimburse, and forever hold harmless the Reston Association, its Board of Directors, officers, employees, agents, volunteers, and members from any and all injuries, bodily injury, costs, damages, causes of action, claims and any consequential and incidental damages, including attorneys fees, arising out of or resulting from any injury, death, or damage to property which I or my dependent may sustain, suffer or cause as a result of participation in this Activity, including any such injuries, costs, damages, causes of action, claims and any consequential and incidental damages occurring during, resulting from, or related to any travel to or from the Activity. I am aware of the risks associated with participation in this Activity and hereby accept and assume on behalf of myself or dependent full responsibility for any and all such risks, including, without limitation, the need to check with a physician before engaging in this Activity, including any physical activity associated with this Activity. I understand that participation in this Activity may involve activities where injury can occur and shall be undertaken at my sole risk and expense. I hereby certify that I am physically fit and have not been otherwise informed by a physician. I understand that Reston Association does not employ physicians and that its staff cannot and do not diagnose medical problems. I further represent that I or my dependent currently have and carry health insurance and agree that any claim for medical treatment or other purposes shall be made against such health insurance and that my own or dependent’s own personal health insurance shall be primary insurance and the primary source of health insurance coverage in the event that I or my dependent sustain or suffer any bodily injury or medical crisis while participating in this Activity. I acknowledge that I have read and voluntarily agree to the terms of this Indemnification and Waiver. If any portion of this Indemnification and Waiver shall be held invalid for any reason under the laws of the United States, Virginia, or Fairfax County, those parts that are not held invalid shall continue in full force and effect. In addition, I promise to abide by the rules and regulations adherent to this activity or event and to exercise care and caution for my personal safety and that of my fellow participants. I understand further that Reston’s pathways may have irregularities and I have familiarized myself with these conditions. __________________________________________ Participant Date: _____________________________________ Parent or Guardian Waiver I am the parent or guardian of _________________________________, a minor, and on the minor’s behalf and on my behalf and on behalf of all other parents or guardians of the minor, I accept the release and waiver of liability at the top of this form as inducement for allowing my child, or this minor, to participate in the above named activities or event(s). I further authorize any emergency medical care, which may be necessary. I represent and warrant that I have the authority to give this release. ____________________________________________ Parent/Guardian Date: ____________________________________


I understand that there are no refunds or transfers.

I acknowledge that I am over the age of 18, or the legal guardian of the registrant under the age of 18.

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