INDIVIDUAL & FAMILY RELEASE AND WAIVER OF LIABILITY

By signing this Individual & Family Release and Waiver of Liability (“Waiver”), and for consideration
of participation in this Breakthrough T1D event (“Event”), I fully and completely waive and release
Breakthrough T1D (“Breakthrough T1D”), its chapters, directors, officers, administrators, representatives and executors, past and present employees, volunteers, agents, supervisors, participants, all state and local
governments, assigns, sponsors, their representatives and successors and other persons
(collectively, the “Releasees”), from any and all claims, liabilities, damages, and/or causes of action arising out of an injury to me (or my dependent) and from any and all claims, liabilities, damages, and/or cause of
actions arising from, or relating to, my (or my dependent’s) participation or attendance in the Event.

Inherent and Potential Risks

I understand that the Event involves strenuous physical activity and that physical activity, by its very
nature, carries with it certain inherent risks. I assume all risks associated with participating in the
Event relating to the risk of strenuous physical activity, collisions with other participants, or falling. I
acknowledge that I (or any person listed on this Waiver) may incur minor injuries, major injuries, and
catastrophic injuries including paralysis and death. I assume all risks from contact with other
participants and volunteers (including, but not limited to, contracting a disease), collisions with other
participants, vehicles, and pedestrians, negligent or wanton acts of other participants and volunteers,
any defects of conditions of road surfaces (including uneven or wet road surfaces or gravel on the
road surface), failure of other participants, vehicles, and non-participants to observe traffic signals or
laws, and the effects of weather including high heat, thunderstorms, lightning, precipitation, cold
temperatures, high winds, and/or humidity. I assume all risks associated with consuming any food or
drink available at the Event. I am solely responsible for any adverse health effects from food or
beverage consumption, regardless of any allergy, known or unknown, that I (or any person listed on
this Waiver) may have.

I agree to dress myself (or my dependent) appropriately as to mitigate the risk of physical injury to
myself (or my dependent) including, but not limited to wearing the appropriate clothing and footwear
required for the type of physical activity at the Event, and use of specific gear for the Event (walking
shoes, running shoes, clothing, bike helmet, properly maintained bike) and dressing in conjunction
with the weather.

I agree that the Releasees are not responsible for any personal items or property lost or stolen
before, during, or after the Event.

For the safety of community and all participants in the Event, Breakthrough T1D’s national policy
is to have events free of weapons and therefore, weapons are strictly prohibited at all
Breakthrough T1D events. I agree not to bring a weapon of any kind to the Event, including all
Breakthrough T1D sponsored pre and post Event activities. The Breakthrough T1D requests your
adherence to this policy.

Medical Evaluation

I attest that I (or any person listed on this Waiver) am medically and physically able to participate in
the Event. If I experience any doubt as to my (or any person listed on this Waiver’s) ability to
successfully and safely participate in and/or complete the Event, I take full responsibility for
consulting a physician. I attest that, if I (or any person listed on this Waiver) am pregnant, disabled in
any way, or have recently suffered an illness, injury, or impairment, I (or any person listed on this
Waiver) should have or did consult a physician prior to participating in the Event. I consent to
emergency medical care and transportation in the event of injury to me (or any person listed on this
Waiver) as medical professionals may deem appropriate. This Waiver extends to any liability arising
out of or in any way connected with the medical treatment and transportation provided in the event of
an emergency, including, but not limited to, negligent emergency rescue operations.

Voluntary Participation 

I am fully aware of the risks connected with participation in the Event, whether specifically listed in
this Waiver or not, and I voluntarily elect to participate in the Event knowing that my participation
involves these risks. My voluntary participation and waiver also acknowledge any additional risks
occasioned by any inherent or previously existing physical limitations, whether known to me or not,
that I or my dependent may have.

Assumption of Risk, Waiver of Liability, Release, and Covenant Not To Sue 

In consideration for being permitted to participate in the Event, I voluntarily agree for myself, my
family, heirs, assigns, executors, and administrators to the following:

• TO ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, OR PERSONAL INJURY,
  INCLUDING DEATH that may be sustained by me (or any person listed on this Waiver), or
  any loss or damage to property owned by me (or any person listed on this Waiver), as a
  result of participating in the Event.
• TO RELEASE, WAIVE, HOLD HARMLESS, DISCHARGE, AND COVENANT NOT TO SUE the
  Releasees from any and all liability, claims, actions, demands, expenses, attorney fees,
  breach of contract actions, breach of statutory duty or other duty of care, warranty, strict
  liability actions, and causes of action whatsoever, that I might have or acquire in the future,
  arising out of or related to any loss, damage, or injury, including death, that may be sustained
  by me (or any person listed on this Waiver), or to any property belonging to me (or any
  person listed on this Waiver), while participating in the Event including, but not limited to, any
  claim that the act or omission complained of was caused in whole or in part by the negligence or carelessness of the Releasees.

Acknowledgement and Compliance with Rules

I agree to observe all rules and safety procedures that accompany Walk and to abide by any
decision of an Event official relative to my (or my dependent’s) ability to safely participate in the
Event. I agree to exhibit appropriate behavior at all times and to obey all laws. Breakthrough T1D
and Event officials may dismiss me (or my dependent), without refund, should my (or my dependent’s) behavior
endanger the safety of or negatively affect an event, person, facility, or property of any kind.

Contagious or Infectious Disease Acknowledgement

I hereby acknowledge and understand my participation includes the possible exposure to and illness
from contagious or infectious diseases, such as COVID or the Flu. I accept the risk of life-threatening
illness, temporary or permanent disability, or even death. I understand that Breakthrough T1D cannot
guarantee that I will not become infected with a contagious or infectious disease and that being at
this event may increase my risk of contracting such disease or illness.

Further, I knowingly and voluntarily agree to follow all required and relevant federal, state, local, and
Breakthrough T1D guidelines and recommendations to maintain the health and safety of event
attendees. I will not participate in the ride if I am sick or if I have knowingly been exposed to
someone with symptoms of an infectious or contagious disease. Prior to the event, I acknowledge
and agree that I will fully and truthfully fill out and sign any waivers, releases, and/or questionnaires
that may be required of me by Breakthrough T1D as a condition to volunteering at the event.

Severability

I agree that if any portion of this Waiver is deemed to be invalid, the remainder of the Waiver will still
be binding and enforceable.

Dependent Registrations

If I am registering children, I attest that I am in fact the parent or legal guardian of the participant(s). I
hereby give my approval to this individual’s participation in the Event. I assume all risks and hazards
incidental to such participation, and I hereby waive, release, absolve, indemnify, and agree to hold
harmless Releases for any claim arising or any injury to my dependent and from any and all liability,
claims, actions, demands, expenses, attorney fees, breach of contract actions, breach of statutory
duty or other duty of care, warranty, strict liability actions, and causes of action whatsoever arising
out of or connected with my dependent’s participation in the Event. I consent to the foregoing and
grant permission for my dependent to participate in the Event. I attest that if my dependent is under
sixteen (16) years of age as of the date of the Event, they will be accompanied by an adult eighteen
(18) years of age or older throughout the entirety of his/her participation in the Event.

Photography and Website Release

I agree that, during the course of the Activity, Breakthrough T1D may photograph and video me (or
any person listed on this Waiver). I hereby grant full permission to Breakthrough T1D to use, reuse,
reproduce, publish, or republish any photographs, motion pictures, recordings, or any other record of
my (or any person listed on this Waiver) participation in this event, including all Breakthrough T1D
sponsored pre and post event activities, in any medium now known or hereafter developed, alone or
in conjunction with other material, without restriction as to changes or alterations, as well as to use
my (or any person listed on this Waiver) name, voice, likeness, and/or other indicia of identity, for
editorial, educational, promotional, advertising, and commercial purposes, including without limitation
in connection with the solicitation of contributions and the furtherance of the corporate objectives of
Breakthrough T1D.

I grant permission for Breakthrough T1D to publish and recognize my (or any person listed on this
Waiver) participation in the Event on its website and I have reviewed, and I consent to, Breakthrough
T1D's online Privacy Policy found here: Breakthrough T1D Privacy Policy.

I acknowledge and represent that I am 18 years of age or older, I have carefully read and
understand all terms of this the Event Release and Waiver of Liability, and if I am registering
dependents, I know and understand its contents and I sign and initial for children under the age of
18, the same on my own free act and deed.