Welcome to the Park Brewing run club, presented by Dr. Rebecca Smith, PT, DPT
with Core Values Physical Therapy.

I hereby release Dr. Rebecca Smith, PT, DPT, Core Values Physical Therapy and Wellness PLLC, Park Pizza and Brewing and Tavistock Group, and waive all responsibility on their part for any liability with respect to me participating in this run club event. This waiver and release extends to all activities pertaining to this running club and shall release Dr. Rebecca Smith, PT, DPT, Core Values Physical Therapy and Wellness PLLC, Park Pizza and Brewing and Tavistock Group and any volunteers from liability.

I can attest that I am sufficiently physically fit and do not have any medical conditions that would limit my ability to participate or put me at risk.

Participating in this run club is strictly voluntary on my part.

Any athlete participation in the run club carries with it a risk of injury that cannot be eliminated regardless of the care taken to avoid such injuries and the undersigned individual shall assume all risk by participating in the run club.

I also agree to be contacted by the run club in the future. We will not share your personal information here onto per Core Values Physical Therapy and Wellness, PLLC’s privacy policy.

By typing my full name below I authorize the run club and its associates to collect and publish photos and/ or videos of the run club. These photos/videos will be used for promotional and informational marketing material.