Registration Forms

Entry Fee: 5K Run -Pre-registration $17.00 ; Race day registration $20.00.
2 Mile walk - $15.
REGISTRATION

Make Ckecks Payable to: Paradise Park - Joe Heyer Memorial Run.

Mail to: P.O. Box 121, Paradise PA 17562. (Mail prior to June 25th).

5K Run _____ 2 Mile Walk _____

Last Name: ______________________ , First Name: ____________________

Street Address: ______________________________ City: _____________________

State & Zip: ___________________

Sex (M/F): ____________ Age as of Race day: _________ DOB: _______________

Shirt Size: Small ____ Medium ____ Large ____

Sign Waiver: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I also know that there may be traffic on the course and assume the risk for running in traffic. I also assume any other risks associated with running or attending the race including but not limited to falls, contact with other participants, the affects of the weather and the condition of the roads, all such risks being known and appreciated by me. Knowing these facts, and in consideration of your accepting my entry fee, I hereby for myself, my heirs, executors, andministrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge the Paradise Park Joe Heyer Memorial 5K Run/Walk committee and their heirs, the Townships of Paradise & Leacock, any and all sponsors including their agents, employees, assigns or anyone acting on their behalf from any or all claims or liability for death, personal injury or property damage of any kind. This waiver extends to all claims of every kind or nature what so ever, foreseen or unforeseen, known or unknown.

I HAVE READ AND UNDERSTAND THIS WAIVER: (If under 18, legal guardian must sign).

Signature: ________________________________ Date: ______________________

Enter content here