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Registration

User Information

Name(Required)

First Last

Email(Required)

If you have a @wfu.edu email, please use that email address.

General Information

Gender(Required)

Male

Female

Non-binary

Other

Other Gender Specification(Required)

Bio(Required)

Image

Accepted file types: jpg, gif, png, Max. file size: 23 MB.

Recommended photo size: 250 x 250.

Classification(Required)

First Year

Sophomore

Junior

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Alumni

Faculty / Staff

Graduate Student

Community Member

Event Information

What is your personal goal to raise?(Required)

What size t-shirt do you want?(Required)

Is there anyone you are running in honor of?

Team(Required)

Enter your new team's name (formal organization name, first-year hall, or department)(Required)

Enter a team nickname if you like (this will be your display name)

Select the category or division for your team.(Required)

What is your team's goal to raise?(Required)

Safety & Medical Information

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Agreement Information

Please read the following agreement:(Required)

Release and Assumption of Risk Agreement (scroll to view full message)

This Release and Assumption of Risk Agreement (this “Agreement”) pertains to Activity described below.

Activity: Hit the Bricks
Sponsor: Wake Forest University (“Wake Forest”), acting through the Office of Civic and Community Engagement

Activity Description: Hit the Bricks is an 8-hour relay race around Hearn Plaza. Participants will run, walk and otherwise make their way around the brick pathway to complete as many laps as possible for their team. Participants will run and walk alongside hundreds of other individuals and have the opportunity to engage in special lap challenges. There will also be games for participants on the in-field quad area. The event concludes with a ceremonial remembrance lap before participants gather in front of Wait Chapel for a moment of silence to honor all those who have lost their lives to, or are fighting the battle against, cancer. Participants are raising awareness and funds to find a cure for cancer. All proceeds benefit the Brian Piccolo Cancer Research Fund at Atrium Health Wake Forest Baptist. ____________(Scroll for rest of agreement)__________________

In consideration of the opportunity to participate in the above-identified activity, the undersigned agrees to the following:

1. Voluntary Participation. I understand that Wake Forest does not require me to participate in the Activity. I voluntarily choose to participate and I voluntarily assume all risks associated with taking part in this Activity.

2. Risks. During the Activity I will have the opportunity to participate in certain activities which may expose me to potential risks and dangers. Some of the risks associated with the Activity include, but are not limited to, illness, physical injuries such as sprains, muscle strains, and abrasions, and/or aggravation of existing health problems. These examples are not intended to be all-inclusive, but merely to exhibit my awareness of the risks inherent in this Activity and I understand and assume these risks.

3. Release of Claims. Knowing the risks described above, and in consideration of being allowed to participate in the Activity, I hereby assume all risks and responsibilities surrounding my participation and I release Wake Forest, its officers, trustees, agents and employees from any and all liabilities, claims, or demands for damages for personal injury, disability, property damage or other loss, damage, or injury of any kind that I may suffer or sustain as a result of my participation in the Activity, unless such injury or damage is caused by the gross negligence of Wake Forest or its employees. To the extent permitted by law, I further agree to indemnify and hold harmless Wake Forest, its officers, trustees, agents and employees, from any and all loss, liability, damage or costs that it or they may incur as a result of my participation in the Activity or arising from or out of any of my acts or omissions related to the Activity.

4. Medical Treatment Authorization. Volunteers and Wake Forest representatives assisting in the Activity are authorized (but are not obligated) to take any actions they consider to be warranted under the circumstances regarding my health and safety while participating in the Activity. I agree to pay all expenses related thereto and hereby release Wake Forest and its officers, trustees, employees and agents from any liability for such actions taken for my health and safety and for payment for any such treatment.

5. I grant Wake Forest the right to use any photographs or video of me taken by Wake Forest or its agents during my participation in the Activity for promotional purposes. The photos and/or video may be seen on local TV news and in Wake Forest University promotional materials or advertisements. I understand that I do not have the right to decide what the material states or how the pictures or video will be used. I understand that I will not be paid if Wake Forest University uses the pictures or video.

6. Binding Effect; Construction; Forum. I acknowledge that this Agreement will be binding on me, as well as members of my family, my spouse, heirs, assigns and personal representative. This Agreement will be construed under the laws of the State of North Carolina, which will be the forum for any lawsuits filed under or incident to this Agreement or to Activity. If any portion of this Agreement is held to be invalid, the balance, notwithstanding, shall remain in full force and effect.

In consideration of the opportunity to participate in the above-identified activity, I knowingly and voluntarily:

1. Acknowledge that I have: (i) had a physical examination and have been given my physician’s permission to participate, or (ii) I have decided to participate in the Activity without the approval of my physician;

2. Represent that I am physically ready to participate in the Activity;

3. Acknowledge that, if I am a Wake Forest employee, the Activity is not within the course and scope of my employment with Wake Forest. I specifically acknowledge my waiver below shall include rights to workers’ compensation benefits for any injury or disability incurred while participating in the Activity;

4. Acknowledge that any Wake Forest personnel or agents attending the Activity are not necessarily medically trained to care for any physical or medical problems of individuals participating in Activity;

5. Agree to follow all the safety procedures and instructions of Activity coordinators (e.g., appropriate dress, proper use of safety equipment, etc.)

6. Acknowledge that due to the on-going COVID-19 pandemic, the Activity is subject to alteration, postponement or cancellation at the discretion of the Activity organizers. If event details change you will be notified via the email you use to register. And while participating in the Activity, I agree to abide by all University and event specific guidelines related to COVID-19.

I am eighteen years of age or older and am fully aware that my participation in the Activity is on a voluntary basis and is not mandatory, and I will receive no academic credit or employment compensation for my participation in the Activity.

_____________________
Note: As part of your registration, you will receive a WFU Hit the Bricks t-shirt. Please note that exact sizing is not guaranteed and priority is given based on the time of your registration.

I agree to terms and conditions written above.

Potential Donors

Please submit the contact information of friends or family members.They will automatically be sent an email telling them about Hit the Bricks 2026 and your participation in the event, and asking if they would be willing to support you by donating to the Brian Piccolo Cancer Research Fund on your behalf

Potential Donor Name(Required)

First Last

Potential Donor Email(Required)

Maximum of 15 potential donors

Add up to 15 repeated fields.