2023 LHI Kids Track - Dyersville | Dyersville, IA

Participant Information

Participant Email *

Participant First Name *

Participant Last Name *

Participant Birthdate *

Participant Gender *

Male

Female

Country *

Street Address (w/Apt#) *

City *

State *

Zip Code *

Phone *

Would you like to receive important event text alerts on this number (eg. changes or delays)?

Emergency Contact Name *

Emergency Phone *

Event Selection

Appropriate events will appear after age division is selected

Age Divisions (Age as of December 31, 2023) *

Age as of December 31, 2023

Individual Events - Participants can select up to 3 events total (2 Track and 1 Field or 1 Track and 2 Field)

Individual Track Events (Select up to 2)

50 Meter Dash

Only for Age Groups 6U and 7-8

100 Meter Dash

200 Meter Dash

400 Meter Dash

800 Meter Run

1600 Meter Run

Individual Field Events (Select up to 2)

Softball Throw

Standing Long Jump

Relay

4x100 Meter Relay

Relay Member 2

Relay Member 3

Relay Member 4

Waiver *

PART A - ATHLETE WAIVER AND RELEASE FROM LIABILITY 

In consideration of being permitted to enter for any purpose any RESTRICTED AREA (herein defined as the areas to which admission by general public spectators is prohibited and in addition, consisting of the planned route, or any other area which the participant chooses to access by any mode of transportation), or being permitted to compete, officiate, observe, work for, or for any purpose participate in any way in the event, EACH OF THE UNDERSIGNED, for himself/herself, his/her personal representatives, heirs, next of kin, acknowledges, agrees and represents that he/she has, or will immediately upon entering any of such restricted areas, and will continuously thereafter, inspect such restricted area or areas and all portions thereof which he/she enters and with which he/she comes in contact, and he/she does further warrant that his/her entry upon such restricted area or areas and his/her participation, if any, in the event constitutes an acknowledgment that he/she has inspected such restricted area and the he/she finds and accepts the same as being safe and reasonably suited for the purpose of his/her use, and further agrees and warrants that if, at any time, he/she is in or about restricted areas and he/she feels anything to be unsafe, he/she will immediately advise the officials of such and will leave the restricted area(s):
               
 1.  HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the Iowa Sports Foundation, its affiliated clubs, the National Sports and State Governing Bodies, the state of Iowa, the city of Des Moines, city of Urbandale, city of West Des Moines, city of Clive, and every other city, county, municipality, or other governmental entity or sponsor in which an event or activity shall be located, their respective administrators, officers, directors, representatives, agents, coaches, the promoters, hosts, other participants, operators, officials, any persons in a restricted area, sponsors, advertisers, owners and leasees of premises used to conduct the event and each of them, their officers, and employees, all for the purposes herein referred to as "releases", from all liability to the undersigned, his/her personal representatives, assigns, heirs, and next of kin for any and all damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the undersigned, whether caused by the negligence of the releases or otherwise while the undersigned is in or upon the restricted area, and/or competing, officiating in, observing, or working for, or for any purpose participating in the event.

2.  HEREBY AGREES TO INDEMNIFY AND SAVE HOLD HARMLESS the releasees and each of them from any loss, liability, damage, or cost they may incur due to the presence of the undersigned in or upon the restricted area or in any way competing, officiating, observing, or working for, or for any purpose participating in the event and whether caused by the negligence of the releasees or otherwise.

3.  HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to the negligence of releasees or otherwise while in or upon the restricted area and/or while competing, officiating, observing, or working for or for any purpose participating in the event.

4.  EACH OF THE UNDERSIGNED expressly acknowledges and agrees that the activities at the event and in the restricted areas are dangerous and involve the risk of serious injury and/or death and/or property damage.  EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
                
5.  MEDICAL RELEASE in the event that I sustain injury or illness while competing in the Iowa Sports Foundation, Inc., hereby authorize any emergency first aid, medication, medical treatment or surgery deemed necessary by licensed medical personnel, I also give my permission for attending medical personnel to execute on my behalf any permission forms and/or other necessary medical documents and to act in my behalf if I am not immediately available to do so.
                
6.  HEREBY CONSENT to allow my picture and/or voice or likeness to appear in any official documentary, promotional, exclusive television, radio or film coverage of the Iowa Sports Foundation, in any manner incidental to my participation in the Iowa Sports Foundation, and without compensation to me.

THE UNDERSIGNED HAS READ THIS WAIVER AND RELEASE FROM LIABILITY, FULLY UNDERSTANDS ITS TERMS, UNDERSTANDS THAT SUBSTANTIAL RIGHTS ARE GIVEN UP BY SIGNING IT, AND SIGNS IT FREELY AND VOLUNTARILY, and further agrees that no oral representatives, statements or inducement apart from the foregoing written agreement have been made.

This waiver, release and indemnification agreement, specifically embraces each and every event sanctioned, authorized, sponsored, or promoted by said releasees during the entire season, including, without limitation, local or regional qualifying events, wherever located, and applies to each and every event, or activity hereinabove mentioned, and has the same effect as if executed after each and every activity or event in which the undersigned participates so that the parties herein intended to be released and indemnified shall be fully and effectively released and indemnified as to each and every event hereinabove described.

Read through the agreement

I have read and agreed to the TERMS *

Is the participant 18 or older? *

18 or older Under 18

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