A Walk for Tom – Participant Declaration & Acknowledgement of Responsibility

Fitness to Participate

Participant Declaration & Acknowledgement of Responsibility

Please read this form carefully before signing.
A Walk for Tom is a community fundraising walk of approximately 20 miles. We have planned the most appropriate route available, but participation is entirely at your own risk.

By signing this form, you confirm the following:(Required)

1. Personal Responsibility & Liability

I understand that I am taking part in A Walk for Tom voluntarily and entirely at my own risk.
I accept full responsibility for my own safety and wellbeing throughout the event.
I agree that neither The Tom Youngs Foundation, its organisers, nor volunteers can be held liable for any injury, illness, loss, or death that may occur during or as a result of my participation.
I agree that I will not pursue any claim or legal action against the organisers in the event of injury, illness, or death.

2. Fitness to Participate

I confirm that I am physically fit and capable of completing a 20‑mile walk.
I confirm that I do not have any medical or health conditions that would make participation unsafe or inadvisable.
I understand that it is my responsibility to seek medical advice if I am unsure about my fitness to take part.

3. Allergies & Medication

I confirm that if I have any allergies, I will bring all necessary medication with me (e.g., inhalers, EpiPens, antihistamines).
I agree to notify Michelle Youngs of any allergies or relevant medical information before the day of the walk, so she is aware in case of emergency.

4. Road Safety

I understand that parts of the route include walking along or near roads.
I agree to take extreme care when walking on or beside roads, including:
Using grass verges wherever possible
Staying alert to traffic
Following all instructions from event organisers or volunteers
I understand that if I am not comfortable walking on roads or near traffic, I should reconsider participating in this event.

5. Conduct During the Event

I agree to behave responsibly, follow the route, and listen to any safety guidance provided.
I understand that I may be asked to stop participating if organisers believe I am unfit to continue or acting in a way that puts myself or others at risk.

I confirm that I have read, understood, and agree to all statements in this declaration.

Participant Name(Required)

First Last

Emergency Contact Name:(Required)

First Last

Emergency Contact Phone:(Required)

Allergies / Medical Information (write "None" if not applicable):(Required)