SANCTIONED AND REQUIRED BY: 
ATHLETICS ONTARIO  
RELEASE, WAIVER AND INDEMNITY 
IN CONSIDERATION of the acceptance of my application and the permission to participate as an entrant or competitor in the 
SouthWestern Ontario Field Series #2

I, for myself, my heirs, executors, administrators, successors and assigns HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE 
Athletics Ontario Officials
City of London
TD Waterhouse Stadium
University of Western Ontario
John Allan
Sylvia Kontra
London Western Track and Field Club Members
Athletics Ontario  
and all other associations, sanctioning bodies and sponsoring companies, and all their respective agents, officials, servants, contractors, representatives, successors and assigns OF AND FROM ALL claims, demands, damages, costs, expenses, actions and causes of action, whether in law or equity, in respect of death, injury, loss or damage to my person or property HOWSOEVER CAUSED, arising or to arise by reason or my participation in the said event, whether as a spectator, participant, competition or otherwise, whether prior to, during or subsequent to the event AND NOTWITHSTANDING that same may have been contributed to or occasioned by the negligence of any of the aforesaid. 
I FURTHER HEREBY UNDERTAKE to HOLD AND SAVE HARMLESS AND AGREE TO INDEMNIFY all of the aforesaid from and against any and all liability incurred by any or all of them arising as a result of, or in any way connected with my participation in the said event. 
BY SUBMITTING this ENTRY, I ACKNOWLEDGE HAVING READ, UNDERSTOOD AND AGREED to the above WAIVER, RELEASE AND INDEMNITY. I WARRANT that I am physically fit to participate in this event. 

Date:_________________________	Print Name:__________________________

Signature: ____________________

(if under 18 years, Parent or Guardian 	or Power of Attorney to sign below) 

Date:_________________________	Print Name:__________________________

Signature: ____________________