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Rock 'n' Roll Running Series

MEDICAL TEAM: Rock 'n' Roll Clearwater 2023

October 8th, 2023

Welcome to the Rock 'n' Roll Sports Medicine Team! Thank you for your interest in volunteering!

The Rock 'n' Roll Sports Medicine Team is a great opportunity for volunteers to gain event medical experience. There is a job for everyone with/without direct patient care experience. Non-medical volunteers will assist with comfort care; while medical volunteers will assist with first aid, evaluation, and treatment. No matter what your level of training is, you are an integral part of the team to keep the runners rockin' as they complete their race!

Please select a shift you are interested in. We do our best to keep volunteers assigned to the shift they requested, but sometimes we need to move people to ensure we have balanced coverage.

We look forward to working with you!

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Your information


Required fields are marked with an asterisk (*).
Birthdate *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
First Name *
Last Name *
Street Address *
City *
State *
Zip *
Contact Number (mobile) *
Emergency Contact Name *
Emergency Contact Phone Number *
Shirt Size (unisex) *
Have you volunteered with the Rock 'n' Roll Sports Medicine Team before? *
What is your Medical Training? *
If 'Other' medical training was selected, please state below
Are you volunteering with someone specific? Write the name/group below.
Other Information (ie. IV Skills, Emergency Medical Experience, Volunteer Group Name, etc.)

Waiver

PLEASE READ CAREFULLY BEFORE SIGNING. If the above listed participant volunteer is under 18 years of age, I acknowledge that the above listed participant volunteer is my child, that I have the legal authority to act for the child and on their behalf. In consideration of the services of Competitor Group, Inc. (“CGI”)and The IRONMAN Foundation, Inc.(“IFI” and collectively with CGI, “Operator”) in allowing me and/or my child to assist and/or volunteer in the above-referenced event, and any related programs, activities, or events (collectively, the “Event”), I understand and acknowledge that by signing below I am legally agreeing to the statements in this Competitor Group, Inc. and The IRONMAN Foundation, Inc. Volunteer Waiver and Release Agreement(“Agreement”).I understand and acknowledge that these statements are being accepted and relied upon by the Released Parties, as defined below. I hereby freely and voluntarily acknowledge and/or take action for myself and/or my child, and on behalf of my and/or their spouse, children, parents, guardians, heirs, next of kin, and any legal or personal representatives, executors, administrators, successors and assigns, or anyone else who might claim or sue on my or their behalf, as follows: 1.I ACKNOWLEDGE AND ASSUME ALL THE RISKS OF VOLUNTEERING IN THEEVENT.I understand that my and/or my child’s volunteering in the Event may involve a risk of physical injury to me or others, damage to mine or other’s property, or other consequences. These consequences might result from the actions, inactions, or negligence of myself, and/or my child, and/or others, or from various conditions of the premises, the equipment used in the Event, and/or the weather. There may also be other risks not known or not reasonably foreseeable, including, but not limited to: falls; dangers of collisions with athletes, vehicles, pedestrians, other participants, spectators, volunteers, or fixed objects; dangers arising from surface hazards, equipment failure, or inadequate safety equipment; and hazards that may be posed by spectators or volunteers(including but not limited to the potential that third party/s may commit criminal or terroristic acts).I understand that unmanned aerial vehicles (“UAVs”, also known as “drones”) may be used at the Event for media or other purposes and accept the risk of a collision with, and any damage or injury relating to, any UAV.I further acknowledge that these risks include risks that may be the result of negligent acts, omissions, and/or carelessness of the Released Parties, as defined below. I understand that I and/or my child will be volunteering for the Event at my and/or their own risk and I agree to assume all the risks incidental to volunteering in the Event including, without limitation, (a) THE RISK OF EXPOSURETO COMMUNICABLE DISEASE(S), INCLUDING BUT NOT LIMITED TO COVID-19,WHICH INHERENTLY EXISTS IN ANY PLACE WHERE PEOPLE ARE PRESENT, INCLUDING BEFORE, DURING, AND/OR AFTER THE EVENT AND ACTIVITIES and (b)the risk that my mental, physical or emotional condition (including any use or abuse of alcohol or prescription or non-prescription drugs), whether disclosed or undisclosed, known or unknown, combined with assisting with these activities could result in injury, damage, death or other loss. Operator cannot anticipate or eliminate risks or complications posed by a participant’s and/or volunteer’s mental, physical (including fitness level) or emotional condition. I acknowledge that I and/or my child is acting only as a volunteer and not as an employee of Operator, and there is no expectation to receive any type of compensation from Operator or any of the Released Parties. I understand that Operator reserves the right, in its sole and complete discretion, to deny any person from volunteering at the Event. If the above listed participant volunteer is under 18 years of age, I give permission for the participant volunteer, as my child, to participate in and/or assist at the Event in the capacity as a volunteer and agree to discuss this Agreement, and specifically, the activities and inherent risks, with my child.2.RELEASEAND INDEMNITY. PLEASE READ PARTS A AND B CAREFULLY. THIS SECTION CONTAINS A SURRENDER OF CERTAIN LEGAL RIGHTS.PART A:TO THE EXTENT NOT PROHIBITED BY LAW, I (THE MINOR CHILD’S PARENT/LEGAL GUARDIAN, IF APPLICABLE) FOR MYSELF, AGREE AS FOLLOWS:•TO RELEASE, WAIVE, COVENANT NOT TO SUE, AND FOREVER DISCHARGECGI, World Triathlon Corporation (“WTC”), IFI, USA Track & Field, all Event sponsors, Event organizers, Event promoters, Event producers, Event staff, Event officials, any sanctioning body, administrators, contractors, vendors, advertisers, race directors, volunteers, athletes, all other persons or entities involved with the Event, and all states, cities, towns, and other governmental bodies and/or municipal agencies and locations in which an Event or portions of an Event takes place, and each of their respective parent, subsidiary and affiliated companies, assignees, licensees, owners, officers, directors, partners, board members, shareholders, members, supervisors, insurers, agents, employees, volunteers, other participants and representatives, and all other persons or entities associated or involved with the Event(individually and collectively referred to in this Agreement as the “Released Parties”)of and from any and all claims, causes of action, damages (including direct, indirect, incidental, special and/or consequential), losses (economic and non-economic), costs, expenses, and liabilities of every kind (“Claims”) that I and/or my child may have, for any injury, damage, death, lost property, stolen property, disposed property, or other loss in any way connected with my and/or my child’s enrollment or participation in and/or assistance with the activities, including use of and/or assistance with any equipment, facilities or premises (and losses resulting from the inherent or other risks of the activities).I UNDERSTAND I AGREE HERE TO WAIVE ALL CLAIMS IAND/OR MY CHILDMAY HAVE AGAINST THE RELEASED PARTIES AND AGREE THAT NEITHER I, NOR MY ESTATE, HEIRS, ASSIGNS OR BENEFICIARIESNOR ANYONE ELSE ACTING ON MY BEHALF, WILL MAKE A CLAIM AGAINST THE RELEASED PARTIES FOR ANY INJURY, DAMAGE, DEATH, OR OTHER LOSS I AND/OR MY CHILDMAY SUFFER; AND•TO PROTECT, DEFEND,INDEMNIFY, AND SAVE THE RELEASED PARTIES HARMLESS(“INDEMNIFY” MEANING PROTECT BY REIMBURSEMENT OR PAYMENT,INCLUDINGATTORNEYS’FEES AND EXPENSES) WITH RESPECT TO ANY AND ALL CLAIMS BROUGHT BY OR ON BEHALF OF ME, AND/OR MYCHILD OR OTHER FAMILY MEMBER/S, A CO-VOLUNTEEROR ANY OTHER PERSON, FOR ANY INJURY, DAMAGE, DEATH, LOST PROPERTY, STOLEN PROPERTY, DISPOSED PROPERTY, OR OTHER LOSS IN ANY WAY CONNECTED WITH THE RISKS OR MYAND/OR MY CHILD’S ENROLLMENT OR PARTICIPATION IN AND/OR ASSISTANCE WITH THE EVENT OR THE ACTIVITIES, INCLUDING WITHOUT LIMITATION USE OF AND/OR ASSISTANCEWITH ANY EQUIPMENT, FACILITIES OR PREMISES, WITHOUT LIMIT AND WITHOUT REGARD TO THE CAUSE OR CAUSES ORNEGLIGENCE, WHETHER PASSIVE OR ACTIVE, OF THE RELEASED PARTIES,AND/OR ANY BREACH BY THE RELEASED PARTIES OF ANY LEGALDUTY.THIS RELEASE AND INDEMNITY SECTIONPART A INCLUDES BUT IS NOT LIMITED TO CLAIMS FOR PERSONALINJURY OR WRONGFUL DEATH (INCLUDING CLAIMS RELATED TOEMERGENCY, MEDICAL, DRUG,AND/OR HEALTH ISSUES, RESPONSE, ASSESSMENT,OR TREATMENT), PROPERTY DAMAGE, LOSS OF CONSORTIUM, BREACH OF CONTRACT, OR ANY OTHER CLAIM, INCLUDING CLAIMS RESULTING FROM THE NEGLIGENCE OF RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE, RELATED TO THE EVENT OR THE ACTIVITIES.PART B: If acting in the capacity as a parent or legal guardian on behalf of aminorchild ,I (the minor child’s parent/legal guardian) for and on behalf of my minor child, agree as follows: I agree here to waive and release, in advance, any Claim or cause of action against CGI, IFI, WTC, or each of their respective owners, affiliates, employees or agents that would accrue to my minor child for personal injury, including death, and property damage resulting from an inherent risk in the activity. The required legal notice from that statute is stated below. NOTICE TO THE MINOR CHILD'S NATURAL GUARDIANREAD THIS AGREEMENTCOMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF CGI, IFI,OR THEIRRESPECTIVE OWNERS, AFFILIATES, EMPLOYEES OR AGENTS USE REASONABLE CARE INPROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED.BY SIGNING THIS AGREEMENTYOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM CGI, IFI,WTC,OR THEIRRESPECTIVE OWNERS, AFFILIATES, EMPLOYEES OR AGENTS IN ALAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OFTHE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS AGREEMENT, AND CGI, IFI,OR THEIR RESPECTIVE OWNERS, AFFILIATES, EMPLOYEES OR AGENTS HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS AGREEMENT.3.I acknowledge and represent that I have no knowledge or reason to know of any personal physical or mental limitations, conditions or other restrictions that would make any activities personally inadvisable or inadvisable for me and/or my child to safely volunteer in the Event.
4.Iand/or my child agree to observe the following code of conduct: 1) not to consume any drugs or alcohol that will impair my and/or my child’s judgment and/or ability to volunteer and assist in the Event; 2) respect the rights, dignity, and worth of every individual at the Event, including athletes, other volunteers, and spectators; 3) not to discriminate against anyone based on sex, ethnicity, religion, ability, or performance; 4) respect all property including but not limited to Event venues, hotels, athletic facilities, and equipment; and, 5) to act professionally and take responsibility for my actions, including demonstrating high standards in respect to my language and actions.5.COVID-19WAIVER.OPERATORHAS PUTENHANCED HEALTH AND SAFETY MEASURESIN PLACEDUE TO THE POTENTIAL SPREAD OF COVID-19. I AND/OR MYCHILD MUST FOLLOW ALL INSTRUCTIONS WHILE VISITINGOR VOLUNTEERING AT ANYEVENT-RELATED VENUE, WHETHER POSTED OR OTHERWISE COMMUNICATED VERBALLY OR IN WRITING.AN INHERENT RISK OF EXPOSURE TO COVID-19 EXISTS IN ANY PLACE WHERE PEOPLE ARE PRESENTAND MAY BE CONTRACTED FROM OTHER PERSON(S) (INCLUDING BUT NOT LIMITED TO ANY CO-VOLUNTEER; PARTICIPANT; SPECTATOR; OPERATORSTAFF, REPRESENTATIVE, OR CONTRACTOR; AND/ORANY OTHER PERSON(S)). COVID-19 IS AN EXTREMELY CONTAGIOUS DISEASE THAT CANLEAD TO SEVERE ILLNESS, PERMANENT DISABILITY, AND DEATH. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND THE WORLD HEALTH ORGANIZATION, SENIOR CITIZENS AND PERSONS WITH UNDERLYING MEDICAL CONDITIONS ARE ESPECIALLY VULNERABLE.BY VISITINGOR VOLUNTEERING AT ANYEVENT-RELATED VENUE, I AND/OR MYCHILD VOLUNTARILY ASSUME ALL RISKS RELATED TO EXPOSURE TO COVID-19, SO IAND/OR MYCHILDMAY VOLUNTEERATTHE EVENT AND THE ACTIVITIES;I AND/OR MY CHILDAUTHORIZEAND CONSENT TO OPERATORSTAFF, REPRESENTATIVES OR CONTRACTORS TO CONDUCT SUCH PUBLIC HEALTH SAFETY SCREENING ACTIVITIES BY METHODS SELECTED BY OPERATOR.6.I hereby authorize medical treatment or care for me and/or my child if deemed advisable in the event of injury, accident or illness by a medical director or any of its agents, employees, volunteers, affiliates and designees, a physician and/or hospital. I agree to be responsible and assume liability for any and all costs incurred as a result of my and/or my child’s volunteering in the Event, not covered by my insurance, including but not limited to, medical care and treatment, ambulance services, hospital stays, and physician and pharmaceutical goods and services. 7.I authorize for me and/or my child and voluntarily consent under the Health Information Portability and Accountability Act (HIPAA) to the release and disclosure of my and/or my child’s protected health information, health services provided to me, and/or any health related information about me and/or my child by a physician, emergency personnel, medical team member or any of the Released Parties’ employees for the purposes of diagnosing or providing treatment to me and/or my child, coordination of care, and for health care operations, including necessary administrative and business functions related to my and/or my child’s protected health information, including but not limited to, the release of my and/ or my child’s protected health information to Operator, a sanctioning body, insurance carriers, medical insurance coordinators, other health care providers, parents/guardians, and/or hospitals. I understand there is no expiration for this health information disclosure authorization; I have the right to revoke this authorization, unless action has been taken in reliance on this authorization, and I understand that treatment will not be conditioned upon this authorization. 8.I grant to Operator, each of their affiliates, designees, assignees, and sponsors the right and permission to photograph, film, record and/or otherwise capture in any media the name, image, voice, written statement, photograph and/or visual likeness of me, my spouse, child/ren and/or my other family members (collectively “images”), with right to sublicense, during the activities or otherwise, without compensation, for use for any purpose in any media (now known or hereafter devised) throughout the world in perpetuity, including but not limited to use in photographs, videotapes, CDs, DVDs, broadcast, telecast, podcast, webcast, recordings, motion pictures, commercial advertisement, promotional materials, and/or any other record of this Event. I understand that all ownership and copyright rights in the images shall be owned by Operator and I waive any inspection or approval rights.9.In no event may I (or anyone else on my behalf) without the prior written consent of WTC: (a) use any intellectual property of WTC and/or its affiliates, including, but not limited to, the IRONMAN®, 70.3®, Iron Girl®, IRONKIDS®, Velothon®, CapeEpic®, 5150®, and Rock ‘n’ Roll® marks and names, the “M-Dot” logo, “K-Dot” logo (collectively, the “WTC IP”)and/or any words or marks that refer to, or are suggestive of, or confusingly similar to, the Event, any Event logo, Event name, Event location, Event date, or Event race distance (collectively, “Event IP”), or (b) sell, market, distribute, or produce any products, events, merchandise, websites, or services that are IRONMAN®-branded, 70.3®-branded, Event-branded, or branded or marked using (i) any Event logo, (ii) any Event name, (iii) any Event IP, or (iv) or any WTC IP (including without limitation the word “IRON” or any foreign translation thereof as a prefix for, or component of, any race, event, trade name, trademark, organization name, club name, or brand of any kind, in each case in any way related to triathlon, triathletes, training, coaching, or any endurance sports).10.AGREEMENT TO ARBITRATE. Any dispute or Claims I and/or my child may have arising out of, relating to or in connection with this Agreement, my and/or my child’s assistance with and/or participation in the Event or activities, or any other aspect of my relationship with Operator: 1) shall be governed by Florida substantive law (without regard to its “conflict of law” rules) and 2) unless settled by direct discussions, shall be determined by binding arbitration as the sole and final remedy for all matters in dispute, administered by the American Arbitration Association (“AAA”) in accordance with applicable arbitration rules as interpreted and governed by the Florida Arbitration Code. AAA arbitrators, acceptable to both myself and Operator, shall conduct the arbitration. Required Venue: I agree that any arbitration proceeding, or any suit or other proceeding must be filed, entered into and/or take place only in Tampa, Florida. I ACKNOWLEDGE AND AGREE THAT THE PARTIES, BY ENTERING INTO THIS AGREEMENT, ARE WAIVING ANY RIGHT TO TRIAL BY JURY IN ANY DISPUTE BETWEEN THE PARTIES.I FURTHER ACKNOWLEDGE AND UNDERSTAND THAT IF A JUDGE WERE TORULE THAT THE PARTIES' ARBITRATION AGREEMENT ISNOT ENFORCEABLE THAT THE PARTIES ARE STILL VOLUNTARILY GIVING UP THEIR RIGHT TO TRIAL BY JURY REGARDING ANY DISPUTE BETWEEN THEM. If any provision of this Agreement shall be deemed unlawful, void, or for any reason, unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.11.CLASS ACTION/CLASS ARBITRATION WAIVER.I acknowledge and agree that any arbitration, suit, countersuit, action or other legal proceeding shall be conducted and resolved on an individual basis only and that I will not bring, voluntarily join, or participate in any class action, consolidated action, representative action, class arbitration, consolidated arbitration, or representative arbitration involving matters arising out of, relating to, or in connection with this Agreement, my enrollment or participation in the activities, or any other aspect of my relationship with Operator. I further acknowledge and agree that any dispute regarding the scope of this class action/class arbitration waiver provision shall be determined by a court, not an arbitrator.12.Operatormay assign this Agreement to other entity/s or individual/s(“assignees”) at any time, and any such assignment will grant assignees the full rights and protections accorded in this Agreement, consistent with Operator’s and other Released Parties’ rights and protections under this Agreement. I AFFIRM THAT I AM EIGHTEEN (18) YEARS OF AGE (OR WILL BE ON THE DATE OF THE EVENT) OR OLDER, I HAVE READ THISWAIVER AND RELEASEAGREEMENT, I UNDERSTAND ITS CONTENT, AND INTENTIONALLY AND VOLUNTARILY SIGN IT.FOR PERSONS UNDER EIGHTEEN(18) YEARS OF AGE, A PARENT OR LEGAL GUARDIAN MUST ALSO SIGN THIS AGREEMENT.