Personal Information

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I, __________________(name) intend to participate in the 5k run/walk to benefit brain tumor patients at the Lillian S. Wells Department of Neurosurgery at the University of Florida. I understand that there may be certain dangers and exposure to physical injuries in pursuing this fundraising effort, and I hereby voluntarily assume all risk to myself and my property arising from my participation in this run/walk. I assume such risks regardless of their causes. In consideration of University of Florida permitting me to participate in this fundraising effort, I will not hold the Sponsors of or Contributors to this event, University of Florida Board of Trustees, Board of Governors, the State of Florida, or their trustees, officers, agents or employees, in both individual and representative capacities, liable for damages for any injuries I might sustain while getting to, during, or while leaving this activity. I release, discharge, and hold forever harmless the aforementioned parties from any and all liabilities, claims, damages, or losses stemming from injury to person or property that arises from, or in any way relates to my participation in this activity. I have carefully read this Release and Assumption of Risk and fully understand its contents. I voluntarily sign it and realize that this will bind me, my heirs, and personal representatives. (Note:  Parent or guardian must sign if participant is less than 18 years of age)

Guest Information