Professional Documents
Culture Documents
Mail: Sen. Adriano Espaillat, attn: David Baily, 5030 Bway, #701 NYC 10034
Fax: 212-544-0256 E-mail: eventsRSVP@adrianoespaillat.org
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Youth Sm _____ Youth Med _____ Youth Lg _____ Adult Sm _____ Adult Med _____
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I think that there are inherent risks and potential for injury when participating in an event such as the Uptown Games, including but not limited to
falls, contact with other participants or spectators, effects of weather, conditions on the track or surrounding areas, and physical exertion, and I
hereby assume all such risks and responsibility for any and all injury, damage or loss that may result from participation in the Uptown Games. I
represent that my child is physically fit to participate in the Uptown Games, and is not subject to any medical condition that poses any risk of harm
to him/herself or others. I, for myself, my child, and anyone entitled to act on our behalf, do hereby release the New York Road Runners, Inc., the
Armory Foundation, the City and State of New York and its agencies and officials, and all other sponsors of the Uptown Games and the
representatives and successors of all of the foregoing, from any and all present and future claims and liabilities of any kind, known or unknown,
arising out of my childs participation in the Uptown Games. I grant permission to the foregoing persons and entities to use or authorize others to
use any photographs, motion pictures, recordings, or any other record of my or my childs participation in the Uptown Games or related activities
for any legitimate purpose without remuneration.
Senator
Adriano Espaillat
Councilmember
Ydanis Rodr iguez
Date ________________