The Waiver

Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Date of Birth *

MM

DD

YYYY

Media Consent *

I give permission for photo/videos taken during the event to be used for Summit Mentality and Getahead Promotional Purposes. Please note if you do select no you will not receive post event photos.

Yes

No

Waiver and release of liability *

I understand that participating in this Backyard Ultra involves physical activity that may carry risks of injury. I confirm that I am physically fit and able to participate. I take full responsibility for my health and wellbeing during the event. I agree to release Summit Mentality, Getahead, event organisers, and partners from any liability for injuries or damages that may occur as a result of my participation. I agree to follow all event rules and directions from organisers at all times.

I have read and agree to the waiver and release of liability