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1-108 Field Artillery

Sk Fun Run/Race Hold Harmless Agreement

I, the undersigned, hereby agree that I wish to participate in the 1-10S Field Artillery
Sk Fun Run/Race.

I realize that in any sponsoring event there is the chance of injury or death and that in order that I
participate, I must agree as follows: I agree that the 1_10Sth Field Artillery, the PA Army National
Guard, Carlisle Borough or North Middleton Township or any sponsor of or contributor to the event,
their members, employees, agents and representatives will not be held responsible for any injuries
(including fatal) that I might incur.

I release and forever discharge the 1-10Sth Field Artillery, the PA Army National Guard, Carlisle
Borough or North Middleton Township or any sponsor of or contributor to the event their members,
employees, agents, and representative, from any claims arising from any injuries I might incur,
including death, and from any and all claims, demands, damages, actions, and causes of action of
whatever kind and nature which I might have as a result of any injury that I might incur.

As further consideration for allowing me to participate in the event, I further agree to indemnify and
hold harmless the 1-10Sth Field Artillery, the PA Army National Guard, Carlisle Borough or North
Middleton Township or any sponsor of or contributor to the event, their members, employees,
agents and representatives, and all persons on their behalf (or brought by my parents, if a minor) on
account of any claims, damages, actions and causes of action of whatever kind and nature arising out
of the aforesaid event.

I further acknowledge that prior to engaging in the activity, I have completed a pre-screening with
my health care provider and that I am cleared to participate without restriction in this event.

I HAVE READTHE ABOVE AND FULLY UNDERSTAND ITS PROVISIONS.

NOTE: PARENTSMUST SIGN ON BEHALFOF ANY CHILD UNDER THE AUDER AGE is.

Date: _

Signature: _

Name (Printed): ..,...- _

On behalf of minor child: _


Print name of minor child