First Name * Last Name * Address * Telephone Number Fairmont State Email Address * Emergency Contact * Emergency Contact Phone Number * Shirt Size * Small Medium Large Extra Large Double Extra Large Events * Red Cross information Class (Jan 31) Red Cross information Class (Feb 28) Red Cross information Class (Mar 28) Red Cross information Class (April 25) Wheels For Wheels (Feb 5) Spinning For Wheels-Feb 23 @ 9am Spinning For Wheels-Feb 23 @ 10am Eating Right Seminar (Jan 29) Eating Right Seminar (Feb 19) Eating Right Seminar (Mar 19) SOUPer Bowl Party Walk A Hound, Lose A Pound Medals 4 Mettals 5K Fun Run/Walk Halo Tournament (Xbox)-April 4th You must complete a separate registration form for each event. Gender * Male Female Division * Student Faculty/Staff Facility Member Community Member NOTIFICATION OF RISK & RELEASE: In consideration of Fairmont State’s allowance of my participation in the Falcon Center, I agree to the extent permitted by law, to release, waive, forever discharge, and covenant not to sue Fairmont State, its governing board, officers, agents, employees, and any students acting as employees, from and against any and all liability for any harm, injury, damage, claims, demands, actions, causes of actions, costs, and expenses of any nature which I may have or which may thereafter accrue to me, arising out of or related to any loss, damage, or injury, including but not limited to suffering and death, that may be sustained by me or by any property belonging to me, in connection with my participation, due to my own negligence or from incidents not specifically attributed to the negligence of Fairmont State, the Falcon Center, the State of West Virginia, its employees, and officials or agents of any and all of the foregoing. I understand that my participation is voluntary and I recognize that there are risks and hazards inherent in my participation to myself and to others, and I assume all responsibility and risk associated with my participation. Confirmation * I have read and understand the contents and the consequences stated in this notification.
