St. Patricks Day 5k Sign Up Form

NOTE: Please fill out the form first THEN PAY

The sign up fee is $20.00

Please Note: Entries are non-refundable, non-transferable and no credits will be issued.
Start and Finish at Tinhouse Brewing Co.550 Sherling Pl, PoCo
Race Day Package Pick up at Tinhouse Brewing
Race Start Time 11:00AM

* Indicates required field

Runners Name *

First

Last

Email *

Phone Number *

Age on Race Day *

Gender *

Male Female

Address *

Line 1

Line 2

City

State

Zip Code

Country

Shirt Size - Available in Unisex *

S M L XL

Please list any medical conditions you have *

Waiver must be signed to enter this event:

Understanding of Risk and Release of Responsibility:
I recognize and understand the risks with participating in a road race. Further that the weather, footing and vehicle traffic conditions may be adverse and greatly increase the danger. I certify that I a medically fit to participate without risk to myself. I understand that I am totally responsible for my own safety. Therefore in consideration of my being permitted to participate as an entrant or competitor in the event. I for myself, my heirs, executors, administrators, successors, and assigns to hereby remise release and forever discharge, waive and save harmless protect and indemnify the Race Organizers of the road race identified above, associations, sanctioning bodies, sponsoring corporations, sponsors, participants, competitors, entrants and all respective agents, officials, servants, and representatives from and against any and all kinds of action claims, costs and expenses and demands in respect of death, injury, loss or damage to my person or property whosoever caused out of me being permitted to attend or in any way take part prior to, during or subsequent to these events whether as an entrant, competitor, spectator, or otherwise not withstanding that some may have been contributed to or occasioned by the negligence of any of the aforesaid, their agents, officials, servants or representatives. By submitting this entry, I acknowledge having read and agreed to the above waiver, release and indemnifications.

By typing your name below, you hereby agree to the above waiver (Parent's name if runner is under 19 years of age)

Name *

First

Last

Date of Signing (mth/day/yr) *

Submit

Pay for Race now

$20

Note: You do not require a PayPal account to pay, click on Pay with Credit Card

st. patricks day 5KRun/Walk Sign Up​Saturday, march 14, 2020

NOTE: Please fill out the form first THEN PAY

Pay for Race now

st. patricks day 5K
Run/Walk Sign Up

Saturday, march 14, 2020