2022 Pleasant Valley Aquathlon/5K Release of Liability & Indemnity Agreement and Model Release
This waiver/release must be signed by all participants or the parent or legal guardian if the participant is under the age of 18.
I acknowledge that the Pleasant Valley Aquathlon/5K and its associated activities involves inherent risks and dangers. I understand that these risks include, but are not limited to, vehicle traffic on and around the course, faulty road conditions, uneven terrain, inclement weather, and the potential for slippery surfaces. I want to participate in Luc’s Run. In exchange for being allowed to participate in Luc’s Run, I hereby agree, on behalf of myself, my heirs, executors, insurers, assigns, attorneys, representatives, agents, beneficiaries, and any other people who might make CLAIMS on my behalf (collectively, “RELEASORS”), to waive, release and forever discharge all of the following people and entities (collectively, “RELEASEES”):
- Pleasant Valley Recreation Association and its directors, contractors, and volunteers;
- Pleasant Valley Aquathlon/5K volunteers, officers, virtual run coordinators, managers, directors, advertisers, agents, representatives, attorneys, and affiliates;
- Fairfax County, the Fairfax County Park Authority, their officers, agents, all employees, and volunteers
- Owners, lessors and lessees of any property on which Pleasant Valley Aquathlon/5K activities take place.
I do hereby waive, release, and forever discharge all RELEASEES from any and all actions, causes of action, lawsuits, controversies, debts, accounts, demands, damages and judgments whatsoever, whether for injury, death or property damage, direct or indirect, known or unknown, foreseeable or unforeseeable, which I may have or acquire (collectively, “CLAIMS”), arising from, concerning, or relating to my participation in Luc’s Run and its associated activities, as well as from any negligent first aid or medical treatment.
I agree also to indemnify RELEASEES from any and all CLAIMS brought by or on behalf of any other person in whole or in part because of my actions.
Assumption of All Risks
I want to engage in Pleasant Valley Aquathlon/5K. I understand that this activity involves risk of serious injury, permanent disability, and even death. I acknowledge and understand that severe social and economic losses may result not only from my action, but also from the action, inaction, or negligence of others, including the negligence of any RELEASEES. I further understand and acknowledge that there may be risks which are not known to me or which are not reasonably foreseeable. I expressly assume all risks which may occur in connection with my participation in Pleasant Valley Aquathlon/5K and its activities and the risk that Pleasant Valley Aquathlon/5K or other RELEASEES may be negligent and such negligence may cause me to be injured. I agree to assume all the foregoing risks and accept full responsibility for my own damages following such injury, permanent disability, or death.
I further acknowledge and represent as follows:
1. I voluntarily wish to enter and participate in Pleasant Valley Aquathlon/5K and its associated activities;
2. I understand that such participation involves arduous and strenuous athletic activities;
3. I am in adequate physical condition to participate in Pleasant Valley Aquathlon/5K;
4. I understand my physical limitations and am sufficiently self-aware to stop physical activity before I become ill or injured;
5. I will obey all rules and regulations for participation in Pleasant Valley Aquathlon/5K;
6. I will inspect and examine all conditions with which I am involved while participating
in Pleasant Valley Aquathlon/5K and, if I observe any condition which I consider to be unacceptably dangerous, I will refuse and refrain from taking part, I will notify the Pleasant Valley Aquathlon/5K race director or coordinator, and I will not take part in the event until the condition has been corrected to my satisfaction;
7. I understand that RELEASEES are not responsible for any inclement weather or other natural conditions or occurrences which may affect Pleasant Valley Aquathlon/5K and that this release and waiver shall encompass all CLAIMS against the RELEASEES arising from or relating
to inclement weather or other natural conditions or occurrences; and
8. I understand that entry fees are necessary to meet the cost of preparation months in advance of Pleasant Valley Aquathlon/5K, and that if Pleasant Valley Aquathlon/5K is cancelled because of fire, drought, storms, Acts of God or other circumstances beyond the control of race management, the entry fee will not be refunded and the Pleasant Valley Recreation Association and Pleasant Valley Aquathlon/5K coordinators will not be held liable.
In the event of injury to me at Pleasant Valley Aquathlon/5K, I consent to emergency medical care and to transportation in order to obtain medical treatment, as needed. This release extends to any liability arising out of, or in any way connected with, any such medical care and/or transportation.
I intend the terms of release and indemnity contained herein to be as broadly applied as is permitted by the laws of the State of Virginia or the jurisdiction of any location in which Pleasant Valley Aquathlon/5K takes place. Any provision or portion of this Release of Liability & Indemnity Agreement found to be invalid by a court shall be invalid only with respect to such provision or portion. The offending provision or portion shall be construed to the maximum extent possible to confer upon RELEASEES the benefits intended thereby.
I have read the above Release of Liability & Indemnity Agreement and understand that by signing below, I give up substantial legal rights.
Further, I grant permission to all the foregoing to use my name, voice and images of myself in any photographs, motion pictures, results, publications or any other print, videographic or electronic recording of this event for legitimate purposes.
Parental Consent (for participants under the age of 18),
I, the parent or legal guardian of the child shown below, have read the above Release of Liability & Indemnity Agreement and agree to its terms on behalf of my child and myself. I understand and intend that by signing below, I am giving up substantial legal rights on behalf of my child and myself.