ACCIDENT WAIVER AND RELASE OF LIABILITY

I acknowledge that this athletic event is an extreme test of a person’s physical and mental limits and
carries with it the potential for death, serious injury and property loss. The risks include, but are not
limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment,
vehicular traffic, actions of other people including, but not limited to, participants, volunteers,
spectators, coaches, event officials and event monitors, and/or producers of the event, and lack of
hydration. These risks are not only inherent to athletics, but are also present for volunteers. I hereby
assume all of the risks of participating and/or volunteering in this event. I realize that liability may
arise from negligence or carelessness on the part of the persons or entities being released, from
dangerous or defective equipment or property owned, maintained or controlled by them or because of
their possible liability without fault.

I certify that I am physically fit, have sufficiently trained for participation in the event and have not
been advised otherwise by a qualified medical person.
I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders,
sponsors and organizers, in which I may participate and that it will govern my actions and
responsibilities at said events.

In consideration of my application and permitting me to participate in this event, I hereby take action
for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A)
Waive, Release and Discharge from any and all liability for my death, disability, personal injury,
property damage, property theft or actions of any kind which may hereafter accrue to me including my
traveling to and from this event. THE FOLLOWING ENTITIES OR PERSONS: Worldwide Sport Supply,
SUNY Broome, Broome County, individual sponsoring companies, the YMCA of Broome County, their
directors, officers, employees, volunteers, representatives, and agents, the event holders, event
sponsors, event directors, event volunteers; (B) Indemnify and Hold Harmless the entities or persons
mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this
event, whether caused by the negligence of releasees or otherwise.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury,
accident and or illness during this event.

I understand that this event or related activities, may be photographed. I agree to allow my photo,
video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors,
organizers and or assigns.

The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver
to the maximum extent permissible under applicable law.
I hereby certify that I have read this document; and, I understand its content.