Winston-Salem, NC – Sign Up Form (Adult)

In consideration of this application being accepted, I certify that I am the participant (“Adult”) and hereby consent to my participation in the Crazy Running program. I hereby waive and release any and all claims that I may have against Crazy Running LLC (an independently owned and operated franchisee of Crazy Running Franchising LLC), Donald Cowart, Jessica Cowart, Justin Pfruender, Cheryl Pfruender and any other coaches or staff (“Releasees”) from any and all liability, claim, judgment, loss, costs, and expenses arising out of any illness or injury that I may incur or sustain during the program. I have had the opportunity to inspect the premises used for practices and am satisfied with its condition. I understand that, in the event of an injury or illness, a representative of Crazy Running, LLC will try to notify my emergency contact first. In the event that my emergency contact cannot be reached, I authorize Crazy Running LLC to obtain necessary medical treatment for me and hereby release and hold harmless Releasees in the exercise of this authority. I also accept full financial responsibility for such care. I acknowledge that I suffer from the following conditions that may be important for the Crazy Running coaches to be aware of: