WAIVER AND RELEASE OF LIABILITY -- READ BEFORE SIGNING In consideration of being allowed to participate in any way in the Ton of Fun Program, its related events and activities, I, the undersigned, acknowledge, appreciate, and agree that: The risk of injury from the activities involved in this program is significant, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury or death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsibility for my participation. 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. I understand this Fleet Feet Sports location is an independent licensee of Fleet Feet, Incorporated and independently operates this Ton of Fun program. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless _________________________ (No Ties LLC) d/b/a FLEET FEET SPORTS, their agents, employees, coaches, volunteers, officers, directors, franchisors, successors and assigns, the City of (Fort Wayne), and any and all sponsors, their representatives and successors ("Releasees"), 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 Ton of Fun 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. Signature: __________________________________________________ Date: _________________ Name: _____________________________________________________

Must attend a minimum of 10 events out of a total of 24 events held (12 walks, 12 clinics) in order to receive $25 dollar gift certificate reimbursements for weight loss incentives

No Refunds, once registered your in. All registrations are final