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Healthercise online registration form

Contact info

Shirt size/Payment info

The cost of registration is:
20.00

Event waiver

In consideration of being allowed to participate in the Scheurer Hospital Auxiliary exercise fundraiser Healthercise, and to use the facilities and equipment, I do hereby waive, release and forever discharge the Scheurer Hospital Auxiliary, Scheurer Hospital Foundation, Scheurer, instructor Jeanne Putman, Maxine Rice, Laker Schools, Caseville Public Schools, and any officers, agents, employees, representatives, executors and all others from any and all responsibilities or liability for injury or damages resulting from my participation in any activities at said fundraiser. I do hereby release all of those mentioned and any others acting upon their behalf from any responsibility or liability for and injury or damage to myself, including those caused by the negligent act or omission of any of those mentioned or others, acting on their behalf or in any way arising out of or connected with my participation in any activities at the fundraiser. I agree to adhere to the policies set by the Scheurer Hospital Auxiliary. I also release with this signature the use of all photos, videos and Internet publications for the use of Scheurer Hospital Auxiliary and Scheurer.
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