Making Tracks for Celiacs Registration Form
Saturday, May 17, 2014
WAIVER. I, the undersigned, agree to indemnify and hold harmless Holy Family Catholic High School, City of Victoria, Raising our Celiac Kids, the Northland Celiac Support Group, UMB Fdt-Ctr for Celiac Research and the authorized volunteers from and against all claims, damages, losses and expenses, including attorney fees, arising out of the permitted activity or event, if such claim 1) is attributable to personal injury, bodily injury, disease or death, or injury to, or destruction of property, including the loss of use there from and 2) is not caused by the negligent act, or omission, or willful misconduct of Holy Family Catholic High School, City of Victoria, Raising our Celiac Kids, the Northland Celiac Support Group, UMB Fdt-Ctr for Celiac Research, and the authorized volunteers. An adult must accompany all children under the age of 12. A parent or legal guardian must sign if applicant is under 18 years of age.
Signature
(by parent or guardian if
participant is under 18) ___________________________________________________
PRINT OUT THIS ENTRY FORM AND MAIL IT WITH FEE TO
Celiac Run Registration
P.O. Box 1161
Minnetonka, MN 55345
Make check payable to Mass General Ctr for Celiac Research and Treatment
MORE INFORMATION
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