I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately; and, I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless the New Balance, Inc., New Balance Winston-Salem, Thruway Shopping Center, Wake Forest Baptist Medical Center, their agents, employees, coaches, volunteers, officers, directors, successors and assigns, the City of Winston-Salem, and any and all sponsors, their representatives and successors, with respect to any and all injury, disability, death, or loss or damage to person or property associated with my presence or participation, whether arising from the negligence of the releases or otherwise, to the fullest extent permitted by law. I attest that I am in good health and physically capable of participating in the Community Coffee Walk Program, and my medical care provider has approved my participation. Further, I hereby release, consent to, and authorize, in advance, any such use of my name, photograph, voice or likeness by the foregoing parties in any manner they deem appropriate and necessary without remuneration to me. I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS.

No pets permitted. When you register as a participant in the New Balance Winston-Salem Community Coffee Walk you agree that we can share your email information with our program partner Wake Forest Baptist Medical Center's BestHealth program. They will follow-up to provide resources for improving your health.