By registering below, I signify that I desire to participate in the 2017 National Walk@Lunch Day event on April 18, 2017, April 26, 2017, and/or May 4, 2017, in one or more of the following locations: Linn Park, Birmingham, Alabama; Big Spring Park East, Huntsville, Alabama; Riverwalk Stadium, Montgomery, Alabama; and Government Plaza, Mobile, Alabama. In consideration for participating in the above-described activity and with the understanding that such participation is only on the condition that the Releasor enters into this agreement for himself or herself and on behalf of his or her heirs, representatives, and assignees; Releasor hereby forever agrees to:
• Assume all risks involved in, or related to, the above-named activity, as well as all other risks involved in, or related to, any other activities collateral thereto, and accept full responsibility for any and all injuries (including death) and accidents which may occur as a result of participation; and
• Release, indemnify, hold harmless and defend all sponsors and contributors, including but not limited to the City of Birmingham, the City of Birmingham Park and Recreation Board, the City of Huntsville, the City of Montgomery, the City of Mobile, all as applicable, Blue Cross and Blue Shield of Alabama and their subsidiaries and affiliates, and each of their officers, directors, agents, independent contractors, representatives and employees, against all liability, costs, loss, claims, and actions, including negligence, based upon or sustained in connection with my participation in the above- described activity or any other activity or event collateral thereto.
I acknowledge that I have read and understand and agree to the terms and conditions above – National Walk@Lunch Day Release for Exercise Activities Form; I am over 18 years of age and sound mind; I am in good health and have no physical or mental condition which would prevent me from participating in these activities.
I hereby authorize Blue Cross and Blue Shield of Alabama to photograph and/or video my physical likeness, and I hereby further authorize the use and disclosure to the public at large of my name and/or said photographs and/or video footage likenesses and any reproductions thereof by Blue Cross, its licensors, successors and assignees, in or in connection with official communication pieces for educational, promotional and/or publicity purposes.