I, _____________________________, with postal and residence addresses at _________________________________________________________________ hereby confirms and declare that:
I am participating in THE 2008 CLARK FREEPORT INTERNATIONAL MARATHON to be held on January 13, 2008 at Clark Freeport Pampanga of my own free will, desire, and volition.
I hereby represent and warrant that I am physically fit to participate and take part in the marathon and have no known illness, physical defect, or adverse medical condition that would render me unfit to participate in the marathon. Should I subsequently discover any illness, physical defect, or adverse medical condition that would render me unfit to participate in the marathon, I shall advise the race organizers in writing and I shall refrain from participating in the marathon accordingly.
I hereby authorize the race organizer, race sponsors, and/or partners to use my name, photographs, and interviews in connection with the marathon in broadcast and print media, videotapes, etc. without any monetary consideration.
I understand that if and when my identity is challenged by the race organizer, it is my responsibility to prove my identity.
I agree to abide by the decision of the race organizers on any issue relative to my participation in the marathon, including but not limited to falls, contact with other participants, declaration of the winner, effects of weather, including heat and humidity, traffic, race conditions, and other factors that are related to the marathon.
I declare that I understand the conditions and the activity I have entered, will abide by its rules and regulations and that all the above details are true and correct. I am aware and accept that all participants enter at their own risk. Accordingly, on behalf of myself, my heirs, and executors, I hereby waive and release all rights and claims for damages I may have against Clark Development Corporation, ActivAsia Inc., Run and Compete Events Organizer, sponsors and contributors for any illness, injury, death, damage or loss I may sustain during, or as a consequence of the activity. I hereby certify that I am physically fit to participate in the activity and that my fitness has been certified by a licensed physician.
I hereby declare that I have read and understood this Declaration of Fitness and Waiver and that I have executed this document willingly and voluntarily.
IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ______________ 200_ at ___________________.
______________________
Printed Name and Signature
PARENTAL CONSENT
(For Minor Participants)
| _______________________ | _______________________ |
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Signed in the presence of:
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| _______________________ | _______________________ |
| (Name and Signature of Race Organizer) | |