Waiver and Release
In submitting this entry, I, intending to be legally bound for myself, my heirs, executors, and administrators waive, release, and forever discharge any and all rights and claims for damages I have or may have against the organizers of this event including Coughlin Chevrolet, Columbus Running Company, Westerville City Schools, the city of Westerville, the city of Pataskala, the city of Columbus, event principals, its employees, its volunteers, all sponsors and their representatives for any and all claims and damages, demands actions whatsoever in any manner, as a results of my participation in the Coughlin Chevrolet Race Series, including travel to and from the event. I hereby consent to medical treatment in the event of injury, accident and/or illness during the event. I hereby grant full permission to any and all of the foregoing to use my name and likeness in any broadcast, telecast, video, or print media reporting or advertising of the event without compensation. If you are under 18, a parent or legal guardian must sign this form.