Come To Galapagos Marathon and half marathon, San Cristobal Galapagos August 13 or October 15, 2017
Official Registration Form
Please print form, fill in blanks, sign, scan and e-mail both registration form and disclaimer to:.
PERSONAL DETAILS:
First Name:______Surname:______
Date of Birth: ______Age:___Sex______
I.D. Number/ Birth certificate number/passport number (please specify)
______
Marital Status:______Allergies:______Blood Type:______
Food Restrictions______
Mailing address______
Next of Kin’s Address & phone______
EVENT DETAILS:
Event Type: Please specify which event you wish to participate in.
Marathon ____ Half Marathon ____ 10K_____ Aug. 13____ OR Oct. 15____
T-shirt size: Small ___ Medium ___ Large ___ Xtra Large ___
Club Name:______Country:______
Do you wish to sponsor a local runner or support the event in any way other than your greatly appreciated participation? If you yes, please take the time to write to Rick at
All athletes are required to submit this formthrough the Internet to
I______declare that the information given above is correct and I am entering this competitionvoluntarily. I shall not hold Come To Galapagos, LLCand Come To Galapagos CIA.LTDA and the organizers of this race responsible for any mishaps that might occur before, during and after the race. I shall abide by the rules and regulations regarding thisevent.
Signed______Date______Position/Rank ______
DISCLAIMER
Consideration of the acceptance of this entry, I assume full and complete responsibility for any injury oraccident that may occur while I am traveling to or from the event, during the event, or while I am on thepremises of the event. I also am aware of and assume all risks associated with participating in this event,
including but not limited to falls, contact with other participants, effect of weather, traffic, and conditions of theroad. I, for myself and my heirs and executors, hereby waive, release and forever discharge the eventorganizers, sponsors, promoters, Come To Galapagos, LLCand Come To Galapagos CIA.LTDA and each of their agents, representatives, successors andassigns, and all other persons associated with the event, from all liabilities, claims, actions, or damages that Imay have against them arising out of or in any way connected with my participation in this event. I understandthat this waiver includes any claims, whether caused by negligence, the action or inaction of any of the aboveparties, or otherwise.
I understand that the entry fee is nonrefundableand nontransferable.I hereby grant full permission to anyand all of the above parties to use any photographs, videotapes, motion pictures, website images, recordings orany other record of this event. I agree that images of me during the event may be used in any legal manner
without payment to me. Race committee reserves the right to refuse entry to anyone for any reason.
1. Authority to Register and/or to Act as Agent. You represent and warrant to Come To Galapagos, LLCand Come To Galapagos CIA.LTDA that youhave full legal authority to complete this event. If you are registering third parties, you represent andwarrant that you have been duly authorized to act as agent on behalf of such parties in performing thisevent registration. By proceeding with this event registration, you agree that the terms of thisRegistration Agreement shall apply equally to you and to any third parties for whom you are acting asagent.
2. Limitation of Liability; Disclaimer of Warranties. COME TO GALAPAGOS, LLCand COME TO GALAPAGOS, CIA.LTDA SHALL NOT BE LIABLE FOR ANYDIRECT, INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES, RESULTING FROM
PARTICIPATION IN THE EVENT. Come To Galapagos, LLCand Come To Galapagos CIA.LTDA makes no warranty that the Come To Galapagos sites'services will be uninterrupted, secure or error free. Come To Galapagos, LLCand Come To Galapagos CIA.LTDA does not guarantee the accuracy orcompleteness of any information in, or provided in connection with, the Come To Galapagos, LLCand Come To Galapagos CIA.LTDA sites. Come To Galapagos, LLCand Come To Galapagos CIA.LTDA is not responsible for any errors or omissions, or for the results obtained from the use ofsuch information. You understand and agree that any material and/or data downloaded or otherwiseobtained through the use of the Come To Galapagos, LLCand Come To Galapagos CIA.LTDAsites is at your own discretion and risk and that youwill be solely responsible for any damage to your own computer system or loss of data that results fromthe download of such material and/or data.
3. Indemnification. You agree to indemnify and hold each of Come To Galapagos, LLCand Come To Galapagos CIA.LTDA and its officers andemployees harmless from any claim or demand, including reasonable attorneys' fees, made by anythird party due to or arising out of your use of Come To Galapagos, LLCand Come To Galapagos CIA.LTDA Website services or the violation of anyterm of this Liability Waiver or the Come To Galapagos, LLCand Come To Galapagos CIA.LTDA website services.
4. Applicable Law; Consent to Jurisdiction. Come To Galapagos, LLCand Come To Galapagos CIA.LTDA sites (excluding linked sites) arecontrolled by Come To Galapagos, LLCand Come To Galapagos CIA.LTDA from its offices within the United States and Ecuador. By completing this eventregistration, both you and Come To Galapagos, LLCand Come To Galapagos CIA.LTDA agree that the statutes and laws of Ecuador, withoutregard to the conflict of laws principles thereof, will apply to all matters relating to this eventregistration, this Liability Waiver, or other use of the Come To Galapagos, LLCand Come To Galapagos CIA.LTDA sites. You agree that exclusivejurisdiction for any dispute with Come To Galapagos, LLCand Come To Galapagos CIA.LTDA resides in the courts of Ecuador and you furtheragree and expressly consent to the exercise of personal jurisdiction in the courts of Ecuador in
connection with any dispute including any claim involving Come To Galapagos, LLCand Come To Galapagos CIA.LTDA or its affiliates, subsidiaries,
employees, contractors, officers, directors, telecommunication providers and content providers.
5. Severability. If any provision of this Liability Waiver shall be unlawful, void, or for any reasonunenforceable, then that provision shall be deemed severable from this Liability Waiver and shall notaffect the validity and enforceability of any remaining provisions.
I have read and understand all four pages of this registration form and disclaimer and agree to these terms.
Print Name ______
Signature ______Date ______
We’re looking forward to a unique and wonderful event this year and to seeing you here!
Siempre Amor,
Rick
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