MSTF Marathon Tour Registration
Saturday, Feb 10, 10:00 AM, Derby, VT
Registration by mail or 8:30-9:45 day of race
40 and 24 km events, timed and touring divisions.
$ 25.00 – General Public
$ 15.00 – MSTF members
Name:_______________________________________
DOB:_________________ Age on Race Day:_______
Address _____________________________________
Phone #______________________________________
NENSA #________________ (See Waiver on Reverse Side)
More race information/map available at MSTF.net
Or call Peter and Louise Harris (802)334-7676
Or Bob and Ellie Primeau 334-1357, elliebobp@adelphia.net
3892 Darling Hill Rd, Newport, VT 05855
Waiver
1. Identification of Risks. I understand that participation in any skiing activity, including but not limited to participation in, and coaching of activities in cross-country ski competitions, involve risk of serious injury, including permanent disability, death and other losses, due to inactions or negligence of myself or others.
2. Assumption of the Risk. I agree that I am responsible for my safety while participating in activities associated with NENSA, and that such responsibility includes participation only a) when I am both physically and psychologically prepared to participate safely, b) after fully familiarizing myself with the venue before beginning the activity, and c) while using the equipment of a type and condition reasonably necessary to safely participate. I assume all risk connected with responsibility for any injury or loss connected with my participation.
3. Waiver. Aware of the risks and willing to assume them, I hereby release and agree to hold harmless the New England Nordic Ski Association (NENSA), its officers, directors, employees, agents, coaches, trainers, doctors, officials, volunteers, affiliates, event organizers, sponsors, owners of property and trails used by me (Released Parties) from loss, injury, or death to myself or to any other person, or other damage to person or property resulting from my participation in events and competition and any related activities including, without limitation activities in connection with sponsorship, organization or execution of any event and travel to and from such event, whether I may participate as an athlete, coach, volunteer, spectator, or in any other manner associated with NENSA. This release is intended as a waiver of any claim I may have whether based upon negligence, breach of warranty, contract or other legal theory, against any of the above Released Parties, accepting myself the full responsibility for any such loss, injury, death or damage which may result. I intend for this release to also apply to my relatives, personal representatives, heirs, beneficiaries, next of kin, and assigns. If any part of this agreement is determined to be unenforceable, all other parts shall be given full force and effect. This waiver does not release acts of gross negligence or willful and wanton misconduct of any party.
4. Insurance. I currently have, and agree to maintain throughout the time that I train and compete, valid and sufficient medical and accident insurance. I understand that this is my sole responsibility and release all persons and entities from providing this coverage for me.
Signature*:__________________________________
Printed Name: _______________________________
Date:__________________
* Parent/Guardian signature if athlete under 18 years of age
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