The Bellin Women's Half Marathon & 5K is an event to empower the women in our community. Please support them in their efforts by volunteering for this great event. They appreciate you!


Please direct any questions to BWHMVolunteers@emplifyhealth.org

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Required fields are marked with an asterisk (*).
First Name *
Last Name *
Mobile Phone *
T-shirt Size *
Emergency Contact *
Emergency Contact Phone Number *
Do you have any physical limitations that might affect your ability to peform in this position?
Are you a Emplify Health employee? *
If you are volunteering on behalf of a charitable organization, please share the name of that organization.

Disclaimer

WAIVER AND RELEASE OF LIABILITY AGREEMENT
In exchange for being allowed to participate as a volunteer in the Bellin Women’s Half Marathon, Relay & 5K, (“Bellin Women’s”), including participation in all volunteer activities, and all related activities, regardless of whether the activities occur before, during, or after the Bellin Women’s (“Volunteer Activities”), I agree to the following:
I REPRESENT THAT I AM IN GOOD HEALTH and that I do not suffer from any physical condition that would prevent me from safely participating in the Volunteer Activities.
I UNDERSTAND AND FULLY ASSUME ALL RISKS AND RESPONSIBILITIES for losses, costs, and damages I incur as a result of my participation in the Volunteer Activities.
I, FOR MYSELF; MY SPOUSE AND MY MINOR CHILDREN (IF ANY); MY PERSONAL REPRESENTTIVES; ASSIGNS; HEIRS; AND NEXT OF KIN, HEREBY RELEASE, WAIVE, AND DISCHARGE Bellin Memorial Hospital, Inc. (“BMH”), and all of its subsidiaries and affiliates that are under common control; controlling; or controlled by BMH and their officers, directors, employees, contractors, agents, volunteers and anyone acting at the request of BMH with respect to the Bellin Women’s (collectively referred to as “Bellin”), and USA Track & Field, Inc. (USATF) from any and all claims, liability, losses, demands, or damages that I suffer, which arise out of or in the course of my participation in the Volunteer Activities, that are caused, in whole or in part, by the negligence of Bellin. I understand that this Agreement does not apply to injuries caused by Bellin’s reckless or intentional conduct.
I ACKNOWLEDGE that Bellin does not carry or maintain health, medical, or disability insurance coverage for me to participate in the Volunteer Activities, and that I am expected and encouraged to arrive with medical or health insurance coverage in effect.
Photograph/Videotape Authorization: I hereby give Bellin Memorial Hospital, Inc., its affiliates and FinisherPix permission to photograph or videotape me during the run and its related activities, and to use those photographs or videos for any
I HAVE READ, OR HAVE HAD READ TO ME, THE ABOVE WAIVER AND RELEASE OF LIABILITY AGREEMENT. I UNDERSTAND AND VOLUNTARILY ACCEPT ITS TERMS. I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS WAIVER AND RELEASE OF LIABILITY AGREEMENT. I FURTHER HEREBY WAIVE THE RIGHT I HAVE TO BARGAIN FOR DIFFERENT WAIVER OF LIABILITY TERMS.