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South Whitley Fall Festival Donut Run

This event has ended

Legend

In case of emergency, contact:

$ 20.00 per participant: Cash/Checks made payable to: South Whitley Parks Department

Mail Payment to: PO Box 463, South Whitley, IN 46787
BOTTOM PORTION MUST BE SIGNED AND DATED BY PARENT OR LEGAL GUARDIAN IF PARTICIPANT IS UNDER THE AGE OF 18.
I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, named above, to participate in the donut run. In order that my child may receive the proper medical treatment in the event that he/she may sustain injury or illness during the South Whitley Fall Festival Donut Run, I hereby authorize those in charge of the event to obtain or provide medical treatment for my child for such injury or illness during the race, and I hereby hold those in charge of the event and the sponsoring organization, as well as its representatives, harmless in the exercise of this authority.

I further understand that there is always a possibility that my child may sustain physical illness or injury while at the donut run. If this occurs, I hereby authorize the individuals in charge of the race and representatives to refer my child to a medical treatment center (hospital, etc.). I further acknowledge and understand that I will be responsible for any medical bills that may be incurred on behalf of my son/daughter for physical illness or injury that he/she may sustain during the donut run.

Understanding that there is always a possibility that my child may sustain physical illness or injury, I acknowledge and understand that my child is assuming the risk of such physical illness or injury by his/ her participation, and I further release the sponsoring organization and its representatives from any claims for personal illness or injury that my child may sustain during the donut run. I further acknowledge and understand that my child will be responsible for his/her failure to abide by the rules and regulations of the donut run.