TEAM BENFIELD RUNNING SUMMER TRACK PROGRAM Please print and sign the following release and bring it with you. (Parents/guardian must sign for children under age 18.) Name _____________________ Date of Birth ____________ Age as of 6/15/06 _________ Release: I agree to indemnify, hold harmless and defend the Greater Evansville Runners/Walkers Club, the City of Evansville, the Evansville Vanderburgh School Corporation, their respective officers, directors and agents, and all sponsors and volunteers, from and against any claim, liability or action arising out of any injury or death as the result of my participation in this event. I further grant permission for use of my name, race results and/or photographs for publicity and purposes to promote this and future events. This release is binding on the undersigned, his/her heirs, legal representatives and assigns. ________________________________________ ___________________ Signature of Participant/Parent/Guardian Date