I hereby waive any claims against, and RELEASE AND HOLD HARMLESS AND INDEMNIFY NicerFL and any of their employees, staff, volunteers, agents and representatives from any liability, claim, loss, damage, cost or expense arising from my participation in this event. I waive such claims against such organization or any such person, arising directly or indirectly from or attributable in any legal way, to any action or omission to act of any such organization or person in connection with execution of this event. I authorize treatment by a licensed medical physician or licensed medical team in case of any accident or illness that may so arise, or any hospitalization necessary.
I hereby certify that the information I have provided on this form is accurate to the best of my knowledge. Please provide your name and today's date as verification.
Please sign your full name and date if you agree.