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Register for Peaceful Pairings (* indicates required fields)

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Peaceful Pairings -couple:enter "1" attendee:   X $60.00 Enter number of attendees for this type.
Peaceful Pairings for One:   X $35.00 Enter number of attendees for this type.
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Additional information:

I understand that my consent to these provisions is given in consideration of the acceptance of this registration and for being permitted to participate in this event. I am a voluntary participant in this event, and in good physical condition. I KNOW THAT THIS EVENT IS A POTENTIALLY HAZARDOUS ACTIVITY AND I HEREBY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR ANY INJURY OR ACCIDENT WHICH MAY OCCUR DURING MY PARTICIPATION IN THIS EVENT OR WHILE ON THE PREMISES OF THIS EVENT, AND I HEREBY RELEASE AND HOLD HARMLESS AND COVENANT NOT TO FILE SUIT AGAINST ACCORD A CENTER FOR DISPUTE RESOLUTION, VOICES FOR CHILDREN / COURT APPOINTED SPECIAL ADVOCATES, ITS LOCAL AFFILIATES AND ANY AFFILIATED INDIVIDUALS, THE CITY OF BINGHAMTON, and ANY RACE SPONSORS AND THEIR AGENTS AND EMPLOYEES, AND ALL OTHER PERSONS OR ENTITIES ASSOCIATED WITH THIS EVENT (THE �RELEASEES�) FROM ANY LOSS, LIABILITY OR CLAIMS I MAY HAVE ARISING OUT OF MY PARTICIPATION IN THIS EVENT, INCLUDING PERSONAL INJURY OR DAMAGE SUFFERED BY ME OR OTHERS, WHETHER SAME BE CAUSED BY FALLS, CONTACT WITH PARTICIPANTS, CONDITIONS OF THE COURSE, NEGLIGENCE OF THE RELEASEES OR OTHERWISE. If I do not follow all the rules of this event, I understand that I may be removed from the competition. I give my full permission to ACCORD and Voices for Children / CASA and their sponsors to use any photographs, videotapes, audiotapes or other recordings of me that are made during the course of this event. I understand that this waiver and release may be stored electronically and agree that a copy is authentic and admissible as evidence in any future dispute or proceeding.

Please check the box to agree to the above terms and conditions.
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