FIELD MEET UNIT CHALLENGE FRIDAY, 26 AUG FROM 0800-1200

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FIELD MEET
UNIT
CHALLENGE
FRIDAY, 26 AUG FROM 0800-1200
KBAY, RISELEY FIELD
REGISTRATION DEADLINE: 23 AUG AT 1600
COMPLETE ENTRY FORM AND GIVE OR EMAIL TO:
Rachelle Winkler Phone: 254-7636
Email: [email protected]
Quen n Redmon
Phone: 257-8377
Email: Quen [email protected]
Registra on forms also available on-line:
h p://mccshawaii.com/101days/
FIELD MEET UNIT
CHALLENGE
Team Name: ____________________________________________________________
Point of Contact: ____________________________ Phone: ______________________
Unit: ______________________
Email: ____________________________________
Indicate which event(s) each team member will parƟcipate in:
. Joust . Combat Obstacle Course . Truck Tire Flip Race (5-person) . 880 Relay Race .
Big Trike Relay (4-person) . Tug-O-War (5-person) .
TEAM MEMBERS’ NAMES:
EVENT:
_______________________________________________________________________________________
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_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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MCBH MAJOR COMMAND:
□ HQBN
□ CAMP SMITH
□ CLB-3
□ 1/12
□ MCAS
□ 3D RADIO BN
□ CPRW2
□ HQ 3D MARINE REG
□ MAG-24
□ 1/3
□ 2/3
□ 3/3
□ HMLA-367
□ MSWD-24
□ HSM-37
□ OTHER: _________________________________________
WAIVER:
(Must be signed): In considera on for me to par cipate in the Marine Corps Community Services (MCCS) FIELD MEET
UNIT CHALLENGE on Marine Corps Base Hawaii, Kaneohe Bay (herea er called event), I hereby take the following ac ons for myself or
anyone else who might claim or sue on my behalf: (a) I acknowledge that the event includes running and is an arduous test of a person’s
physical and mental limits and carries with it the poten al for death, serious injury and property loss; (b) I acknowledge that certain detrimental physiological changes may occur while I par cipate in the event, including, but not limited to, heat exhaus on and stroke; abnormal heart beat; abnormal blood pressure; and, in rare instances, heart a ack; (c) I acknowledge that there may be other par cipants in
the event and that their ac ons and the equipment that they operate may be unpredictable; (d) I cer fy that I am physically fit and have
not been advised against par cipa on in the event by a qualified health professional ; (e) I agree that, prior to par cipa ng in the event, I
will inspect the event facili es, equipment and areas to be used and, if I believe any are unsafe, I will immediately advise a person supervising the event; (f) I assume all risks associated with the event, including, but not limited to, adverse road condi ons; falls; contact with
other par cipants, effects of weather, defec ve equipment, my personal physical condi on; motor vehicles on the event course; and lack
of hydra on; and (g) in connec on with the event, I forever release from liability under the Federal Tort Claims Act, acquit and discharge
from all known obliga ons, losses, damages, liabili es, injuries, claims, demands, ac ons, causes of ac on and expenses, including without limita on, a orney’s fees and costs, the following persons or en es: United States Government including MCCS and the United
States Marine Corps, and the employees, representa ves and agents of the above.
______________________________________________________________
Signature
_______________________________________
Date
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