Walk, Run, EMPOWER 5k Volunteer Sign-up Form
You will be contacted with further information when we receive your application. Thank you!
Street Address Line 2
State / Province
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
Central African Republic
Cocos (Keeling) Islands
Democratic Republic of the Congo
Turkish Republic of Northern Cyprus
Papua New Guinea
Republic of the Congo
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
Tristan da Cunha
Turks and Caicos Islands
United Arab Emirates
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Are you over 18?
Parent or guardian name and contact information:
I acknowledge that I am at least 18 years of age OR the parent/legal guardian of the runner listed above.
Are you a Community Organization, Student Group or Campus Resource that would like to table at the event?
Are you registering as a Community Organization, Student Group or Campus Resource to volunteer the day of?
Student Group/Organization/ Campus or Community Resource
How many members are in your group?
Waiver and Release WALK, RUN, EMPOWER 5K RUN/WALK, is held at Northwestern Michigan College. WAIVER-REQUIRED (If UNDER 18 years of age your Parent or Legal Guardian must also read and agree to this Waiver and Release) I have read the Walk, Run, EMPOWER 5k Run/Walk entry form, event policies, and this WAIVER AND RELEASE completely and understand it entirely. I agree to be legally bound by the terms of this Waiver and Release. I know that participating in this event is a potentially hazardous activity that may result in injury or death to me, injury or death to others, or damage to my property from known and unknown or anticipated and unanticipated risks. I am fully aware that I should not participate in the event unless I am willing to assume such risks and unless I am emotionally, medically and physically able to do so. It is my sole responsibility to determine if I am emotionally, medically and physically able to participate in this event. I understand the nature of the event and I ASSUME ALL RISKS associated with my voluntary participation including, but not limited to, falls, injuries, contact with other participants, contact with wheelchairs or service animals, contact with vehicles, the effects of the weather, including extreme temperatures and precipitation, vehicular traffic, pedestrian traffic, contact with or interaction with event observers, attendees, volunteers, workers, or news media. Knowing these facts, I, for myself, heirs, executors, administrators or anyone else who might make a claim on my behalf, COVENANT NOT TO SUE, WAIVE ALL CLAIMS AGAINST, AND FULLY RELEASE AND DISCHARGE Walk, Run, EMPOWER, Northwestern Michigan College, NMC VOICES, EPIC RACE TIMING LLC, and any and all sponsors affiliated with the 2017 Walk, Run, EMPOWER 5k Run/Walk. Event participants, officials, workers, volunteers, and any and all officers, directors, employees and other representatives of any of the foregoing, and any successors or assigns of the foregoing (collectively, the “Releasees”) are released for and from ANY AND ALL claims or liability, including without limitation the sole or contributory negligence of any or all the Releasees, whether foreseen or unforeseen, for death, personal injury (whether temporary or permanent), mental or emotional injury, invasion of privacy or property damage arising out of, or in the course of, my participation in the event. I further grant full permission to NMC Student Life and NMC VOICES and the Releasees, and/or agents authorized by them, to use any photographs, video recordings, audio recordings, motion pictures, or other record of the event which contain my name, picture and/or likeness for any purpose without any notice or compensation to me.
I agree to the above terms and conditions.
Anything that you would like NMC Student Life and NMC Voices to know before the event?
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