EmailMe Form - 5K Family Fun Run/Walk

$45.00 registration the day of the event

Name of Person Submitting form: *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code

Phone *

### - ### - ####

Email *

Sponsor Opportunities

Sprint $1500.00 includes 10 registrations

Run $1250.00 includes 8 registrations

Jog $750.00 includes 6 registrations

Walk $150.00 includes 2 registrations

WE ARE OUT OF T SHIRTS

WE ARE OUT OF T SHIRTS!!

Number of adult runners you are paying for
Age 14 & up.

(If choosing a sponsorship above, choose NONE here unless you have additional participants) *

Number Of Kid Runners You are Paying For
Age 6-13

(If choosing a sponsorship above, choose NONE here unless you have additional participants) *

By Clicking Continue You Agree To the Following.

IN CONSIDERATION AND SUBMISSION OF THIS ENTRY FORM, I AM BEING PERMITTED TO PARTICIPATE IN THIS EVENT. I AM A VOLUNTARY PARTICIPANT IN THIS EVENT AND IN GOOD PHYSICAL CONDITION. I UNDERSTAND THIS EVENT IS A POTENTIALLY HAZARDOUS ACTIVITY AND I HEREBY VOLUNTARILY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR, AND THE RISK OF, ANY INJURY OR ACCIDENT THAT MAY OCCUR DURING MY PARTICIPATION IN THIS EVENT OR WHILE ON THE PREMISES OF THIS EVENT. I, FOR MYSELF, MY HEIRS, REPRESENTATIVES, EXECUTORS, AND ADMINISTRATORS, HEREBY RELEASE, HOLD HARMLESS AND COVENANT NOT TO SUE THE SPONSORS, OFFICIALS, VOLUNTEERS, AND ANYONE CONNECTED WITH JOLIET AREA COMMUNITY HOSPICE CORPORATION OR THE JOLIET AREA COMMUNITY HOSPICE 5K, FROM AND AGAINST ANY AND ALL CLAIMS, INJURY OR DAMAGES I MAY SUFFER IN CONNECTION WITH PARTICIPATION IN OR TRAVELING TO OR FROM THE JOLIET AREA COMMUNITY HOSPICE 5K RUN. IN ADDITION, I HEREBY GIVE MY PERMISSION TO ORGANIZERS TO USE ANY AND ALL PHOTOGRAPHY OR VIDEO THAT MAY BE RECORDED DURING THIS EVENT. IF I AM UNABLE TO PARTICIPATE I UNDERSTAND THERE IS NO REFUND OF MY REGISTRATION FEE. CHILDREN UNDER 18 MUST HAVE PARENTAL SIGNATURE TO PARTICIPATE.