Volunteer with Hospital Hill Run

| Hospital Hill Run. 2018

May 30th - June 2nd, 2018
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Registration Information

Required fields are marked with an asterisk (*)
First Name *
Last Name *
Mobile Phone *

A full 10-digit phone number (for example: 555-123-1234, (555) 123-1234, 555.123.1234, etc)
Shirt Size
Are you the leader of a volunteer group/team? *
Are you volunteering as part of the WorkPlace Foot Race presented by BlueKC *
Please select if volunteering with one of these groups
If volunteering with a group not listed above, what is the name of the organization/group/business/team?
If employed or a student, what is the name of your place of work or school?
Job Title or Role
Feel free to share your Twitter Handle with us!
Birthday *

A valid date as MM/DD/YYYY (for example: 12/04/1989)
Please share special requests here. (Course Marshal partner or location, accommodations needed, etc.)
For medical volunteers only: please share if you are a nurse, doctor, EMT, student (plus year in school), etc.


Volunteer Liability Release Form
In consideration of my desire to serve as a volunteer for the Hospital Hill Run, I hereby assume all responsibility for any and all risk of property damage or bodily injury, including traveling to \ from such volunteer activity, that I may sustain while participating in any voluntary effort.

Further, I, for myself and my heir, executors, administrators and assigns, hereby release, waive and discharge Hospital Hill Run and its officers, directors, employees, sponsors, agents and volunteers of and from any and all claims which I or my heirs, administrators and assigns ever may have against any of the above for, on account of, by reason of or arising in connection with volunteering or my participation therein, and hereby waive all such claims, demands and causes of action.

I authorize the use of my voice, photos and video by Hospital Hill Run the Board of Directors, and their officers, employees, sponsors and agents in connection with volunteering at the Hospital Hill Run.

Further, I expressly agree that this release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the State of Missouri, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I currently have no known mental or physical condition that would impair my capability for full participation as intended or expected of me.

I, the undersigned, am at least 18 years of age or I am the parent or guardian of a participant who is less than 18 years of age. I have read this Release and Waiver of Liability and understand all its terms. I execute it voluntarily and with full knowledge of its significance.