5K Run Registration Form

First of May 5K Walk/Run REGISTRATION FORM

Sunday, May 5, 2024, 8:00am check in, 8:30am start CCC, Oregon City Enter from S Beavercreek Rd turn on to Claymont Dr., follow signs for Green Parking Lot #1
Name

First NameMiddle NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Contact Number
Sex
Age on Event Date
In Case of Emergency
Emergency Contact:

First NameLast Name
Relationship
Contact Number
**IF YOU ARE SIGNING UP AFTER WED, APRIL 17TH, YOU MAY NOT BE GETTING A TSHIRT** (T-shirt orders were submitted 4.17.24 and we only ordered a couple extra)

Thank you for supporing and joining us on this 5k, we are excited to have you with us!
Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement
First of May 5k Run/Walk, Waiver & Release Form. I First Name Last Name acknowledge that my participation in the 5k involves a risk of injury, including bodily injury, and assume the risk for the same. On my own behalf and on the behalf of my heirs and legal representatives and to the fullest extent permitted by law, I hereby release and discharge Dani Myers Strength & Fitness and Legacy of Love and their respective directors, officers, affiliates, members, agents and representatives, of and from any and all liability for injury, death or damages and/or any other claims, demands, losses or damages, incurred by me in connection with any aspect of the 5k.
Date

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My Products

5k Race Entry

$35.00 Quantity

In-kind donation

$10.00 Quantity

Total

$0.00

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First of May 5K Walk/Run REGISTRATION FORM

In Case of Emergency

Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement