Alzheimer’s Association Event Agreement

Assumption of Risk, Release and Permission

In consideration of being allowed to participate as a member of the Alzheimer’s Association Alz Stars program (“Program”) in the Marathon, Half Marathon, Century Ride, Triathlon, Climb or Team Relay (the “Event”), I on behalf of myself, my heirs, assigns, and legal representatives, agree to assume all risks of personal injury, death or property loss arising in any way out of my participation and release in advance and hold harmless the Alzheimer’s Association, its chapters, their respective officers, directors, volunteers, employees, sponsors and agents (“Parties”) from any liability and to waive my rights with respect to any and all claims for damages for death, personal injury or property damage, including but not limited to medical bills, lost wages, pain and suffering, attorney fees and court costs, which I may have, or which may hereafter accrue to me as a result of my participation in the Program, even though this liability may arise through no fault of my own, or from the negligence or carelessness on the part of the persons or entities being released, from dangerous or defective property or equipment owned, maintained or controlled by them or because of their possible liability without fault. I am aware of and appreciate the risks inherent in training for and participating in the Event, including the use of public streets and facilities where many hazards exist. I certify that I am in good health, physically fit, and capable of participation in the Program, and my medical care provider has approved my participation. If I am aware of or under treatment for any physical infirmity, ailment or illness, or if I am taking any prescription or over-the-counter medications, my medical care provider knows of and has approved my participation in the Program. I understand, or will educate myself about, the dangers of dehydration and hyponatremia (low blood sodium) and will take precautionary measures to prevent these conditions.

I understand that my name, photograph, voice or likeness may be used by the Alzheimer’s Association and/or Event organizers, their licensees, affiliates and employees in photographs, video and other recordings. I consent to and authorize, in advance, such use and waive any rights of privacy and/or publicity I may have in connection therewith.

Consent and Information Release (“Consent”): I understand that the Program personnel are not licensed physicians and any suggestions or recommendations from them regarding any aspect of my training or physical fitness are not being rendered as medical advice. Notwithstanding anything herein the contrary, I hereby grant permission to the Alzheimer’s Association and other Program personnel to render preventative or first-aid assistance or seek treatment or medical care that it seems reasonably necessary, including hospitalization, for my health and well being. I also give permission to the Alzheimer’s Association and other Program personnel to use and disclose my personal health information (“PHI”) as provided by me to doctors, hospitals, ambulance companies, coaches, family members, and others involved in my care and treatment for purposes related to my treatment, or as necessary to run the Event or as necessary for the proper management and administration of the Alzheimer’s Association.

I agree to the guidelines