Most event communications will come via email, so providing a valid email address is important.

Parent/Legal Guardian (if participant is under the age of 18):

I agree to read for a total amount of minutes or hour(s) and/or number of books during the event time period, January 1, 2012 to February 11, 2012.

Minimum pledge is 1 hour or a minimum of two books. The reading pledge may be completed at any time and place during the pledge period, including the final hours of the Read-a-Thon event on Saturday, February 11 between 10:30 a.m. and 4:00 p.m. All monies pledged must be turned in on or before February 11^th to qualify for awarded prizes.

Would you be interested in learning more about volunteering with the Literacy Council of Frederick County?      Yes       No

My electronic signature designates that I wish to participate in the 2012 In Love with Literacy Read-A-Thon. I understand that individual participants must raise a minimum of $20 to receive an event tote bag. Participants agree to collect all pledge donations and submit them to an authorized LCFC member on or before the day of the event. All of the information that I have provided is correct to the best of my knowledge.

Participant Electronic Signature

(Parent or guardian signature is required if the participant is under 18.)

Participant Parent Signature

In consideration for being permitted to participate in this event, I (agree to assume all risks and to release, hold harmless and covenant not to sue the Literacy Council of Frederick County, the Frederick County Public Libraries, and any designated beneficiaries, sponsors, officials, participating clubs, communities, organizations, friends of the event, and all other government or public entities including, but not limited to, the government of Frederick County and affiliated organizations and all their respective directors, officers, agents, employees and members (collectively, “the releasees”), for any claim, loss or liability that I may have arising out of my participation in the event, including bodily injury, death or property damage, whether caused by negligence or carelessness of the releasees or otherwise.

I intend by the waiver and release of Liability to release in advance, and to waive my rights and to discharge all of the releasees from all claims, losses or liabilities for death, bodily injury or property damage that I may have, or which may hereafter accrue to me, as a result of my participation in this event, even though that liability may arise from negligence or carelessness on the part of the releasees, from dangerous or defective property or equipment owned, maintained or controlled by them or because of their possible liability without fault. I (and/or all members of my team) understand and agree that this waiver and release of Liability is binding on my heirs, assigns and legal representatives.

I am physically capable of completing this event. I (and/or all members of my team) understand I may be asked to provide a doctor’s note or other proof that I am permitted to participate by my primary care health provider. If I am aware of or under treatment for any physical infirmity, ailment or illness, my medical care provider knows of and has approved my participation in this event. I will maintain personal health insurance while participating in the event. I (and/or members of my team) acknowledge that I, and I alone, am solely responsible for my personal health and safety, and the personal property I bring with me.

I will read the event description and rules for participation in the event and I will abide by all rules and regulations established by the event organizers and personnel as well as the local vehicle code. I further agree that my participation in the event is subject to the sole discretion of the organizers of the event and that my participation may be limited for medical or other safety-related reasons.

I understand that my name, photograph, picture, voice, or likeness (collectively “image”) may be used for all promotional purposes related to the event by the Literacy Council of Frederick County and/or the Frederick County Public Libraries, and their successors and assigns, sponsors, beneficiaries, licensees, affiliates, and employees (collectively “grantees”). I (and/or members of my team) hereby grant to the grantees the right to (i) use my image in promotional materials or for any other legitimate purpose, (ii) create composite or computer-manipulated materials from my image, (iii) use, reproduce, publish, exhibit, distribute, and transmit my image in any media, including but not limited to print material, television, film, internet, DVD, and CD-ROM, (iv) assign the above rights to third parties. I waive the right to inspect or approve my image or materials that incorporate my image. I understand that I will receive no compensation in connection with the use of my image. I release the grantees from any liability, damages, or claims resulting from the use of my image, including claims for libel or invasion of privacy. I understand and agree that the terms of this paragraph are binding on my heirs, assigns, and legal representatives.

I have carefully read this waiver of Liability and Agreement and fully understand its contents. I am aware that by signing this waiver and release of Liability, I am waiving legal rights and knowing this, I sign it of my own free will.

Participant Waiver Electronic Signature

(Parent or guardian signature is required if the participant is under 18.)

Participant Parent Waiver Electronic Signature