First name:

Last name:

Email:

Phone number:

Mailing Address:

How will you be paying your registration fees?

Are you part of a team?

If yes, please list your team members.

What is your goal date of completion for the Hike da Boot, and Around da Loop Challenge?

RELEASE, WAIVER AND INDEMNITY

I herby state that I am of reasonable fitness to participate in the Hike da Boot and Around da Loop Challenge, furthermore referenced as "The Challenge".

I understand that there is no supervision provided for The Challenge.  I am participating in The Challenge of my own free will.  I fully understand the risks and benefits and accept all consequences as a result of my participation.  I hereby hold harmless, waive and release Eastern Health and its employees, agents, organizers, representatives and volunteers of Eastern Health from any liability, responsibility, demands or claims of any kind arising out of my participation in The Challenge.  By selecting "I Accept", I hereby indicate that I have read and understand this Disclaimer of Liability.  I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.