Location & Date

Carrollwood Day School
Athletic Complex
1515 West Bearss Avenue
Tampa, Florida 33613
map »
Sat. October 29, 2022

Contact & Other Information

Nayda Hawkins
Patriot Run Coordinator
e-Mail Event Organizer





Patriot Run Waiver 
(NOTE: Right Click to Print)
This release is a contract with legal and binding consequences, and it applies to all races and activities at the event. In consideration of the acceptance of my application for entry in the above event(s). I hereby freely agree to and make the following contractual representations and warranties. I acknowledge that: (i) running walking is a potentially hazardous activity; (ii) I should not enter and run or walk unless I am medically able and properly trained; (iii) I hereby certify that I am in good health and I have trained to run or walk the distance of the race which I am entering; (iv) I fully assume all risks associated with running/walking this event including, but not limited to: falls, contact with other participants, the effects of weather including high heat and/or humidity, my own or others’ negligence, and conditions of the course, all risks being know, acknowledged and appreciated by me. Having read this waiver and knowing these facts, I, for myself and anyone entitled to act on my behalf, hereby waive, release, discharge, hold harmless and promise not to sue Carrollwood Day School Education, Inc., its officers, directors, agents, volunteers and employees, all sponsors, their representatives and successors (collectively, the “Releasees”), from any and all claims or liabilities of any kind I may allege against the Releasees as a direct or indirect result of injuries arising out of my participation in this event.

Participant print name:
______________________________________ Date: ___________ Age: ________

Participants Signature: _____________________________________________________

Consent and Release of Parent or Guardian for person under eighteen (18) years of age

I am the parent or guardian of ________________________________. My child is fit for the event and I consent to my child’s participation. I have read and understand the above contract/entry form. In consideration of allowing my child to participate, I consent to the contract/entry form and agree that its terms shall likewise bind me, my child and our heirs, legal representatives and assignees. I hereby waive, release, discharge, hold harmless and promise not to sue the Releasees from any and all claims or liabilities of any kind that I or my child may allege against the Releasees as a direct or indirect result of injuries to my child arising out of my child’s participation in the event.

Signature of Parent or Guardian: ______________________________________________

NOTE: Right Click to Print and SIGN






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