Volunteer Signup

Note: You may not volunteer for Shifts 1 and 2 on the day of the race if you are running in the race.

Required Fields

First Name:		MI:		Last Name:
Mailing Address:
Address Cont.:
City:		State:	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY	ZIP:
E-mail:

Are you planning to walk/run in the race?	Yes   No
Have you volunteered with the race before?	Yes   No
Past Position?
Are you willing to work more than 1 shift?	Yes   No
Organization if Volunteering with a Group:
If you are registering for a group, please list the volunteer names:
Is everyone in your group working the same shift?	Yes   No
Check the shifts you are willing to work:
	Saturday, October 1 Shift 1 - 6:30am-10:30am
Shirt Size:	Women's Medium     Women's Large     Women's XL     Women's XXL     Men's Medium     Men's Large     Men's XL     Men's XXL
Additional Comments:
Cone Health Assumption of Risk and Release and Indemnity Agreement (Must be over 18): In consideration of being allowed to participate in the 2011 Women's Only 5K Walk & Run ("the race"), I acknowledge and agree as follows: I know that participating or volunteering in a road race is a potentially hazardous activity. Some of the risks I may encounter include but are not limited to: falls; contact with other participants; the effects of the weather, including heat stroke, heat exhaustion or dehydration; getting lost or separated; and being struck by vehicular traffic. I agree to assume all inherent risks and all other risks, including those not specifically mentioned above. I understand that I am responsible for ensuring that I am medically able and properly trained to complete the race or volunteer but also agree to abide by any decision of a race official relative to my ability to safely complete the race. I, for myself and anyone entitled to act on my behalf, waive and release The Moses H. Cone Memorial Hospital and its subsidiaries and affiliates ("Cone Health") and all sponsors, agents, employees, officers, directors and volunteers working for Cone Health from all claims and liabilities of any kind, arising out of or related to my participation in the race and any other activities connected to the race. This release includes and prohibits all types of claims, including those for breach of contract, injury, loss, damage or death. I understand that event photographs and/or video images will be taken on the eve and day of the race. I freely give my permission for use of such photographs and video images in future Women's Only race event promotions without further communication or compensation. I also agree that any dispute or suit I have will be resolved using the laws of the state of North Carolina. Any mediation, suit or other proceeding must be filed or entered into only in North Carolina. Any portion of this document deemed unlawful or unenforceable is severable and shall be stricken without any effect on the enforceability of the remaining provisions.
I Agree with the Terms   I Disagree with the Terms