Name *

First Name

Last Name

Do you feel you are in a healthy condition to participate in the Family Fun Run? *

Yes, I agree

At any point during your participation during the Family Fun Run are you able to make a conscience decision to stop and or opt-out of the Family Fun Run activities? *

Yes, I agree

I understand that there is no coverage for losses due in any way from communicable disease including Coronavirus disease (COVID-19). *

Yes, I agree

Do you agree to the following statement? *

I, (the above mentioned), acknowledge that my participation in the Family Fun Run (Walk, Run, Jog) involves a risk of injury, including bodily injury. I assume any and all risk of injury, including bodily injury or any circumstances of the same. On my own behalf and on behalf of my heirs and legal representatives and to the fullest extent permitted by law, I hereby release and discharge 1) Nonprofits, Colossal Contributions and Welcome to Wellness, of their respective directors, officers, employees, affiliates, members, agents and representatives, as well as 2) Mumford High School and the Detroit Public School District of the City of Detroit of their respective directors, officers, employees, affiliates, members, agents and representatives, of and from any and all liability for injury, death, or damages and/or any other claims, demands, losses or damages, incurred by me in connection with any aspect of the Family Fun Run (Walk, Run, Jog). If I am an employee of Colossal Contributions or Welcome to Wellness, I acknowledge that my participation in the Family Fun Run (Walk, Run, Jog) is completely voluntary and does not constitute part of my work-related duties. I understand that my decision to participate, or not participate, in this activity will not affect my job status or connection with said nonprofit.

Yes, I agree