Welcome Runners!

First Name Last Name

Address

City State Zip Code
Phone Email Age Female Male

T-shirt Size Desired

SMALL MEDIUM LARGE X-LARGE

Please Read and Check The Waiver Statement Below:

"A physical examination is not required to run in this event, however, all competitors participate at their own risk. If in doubt regarding your physical condition to engage in a 3.1 mile run, it is strongly recommended that you seek the advice of a competent physician. All persons under 18 years of age MUST have written consent from their parent/legal guardian to compete in the above-mentioned event. In consideration of this entry, I hereby, for myself, my heirs, executors & administrators waive any and all rights to damages I may have against Neighbors' House NFP, individuals associated with this event, their representatives, successors and sponsors for any and all injuries including, but not limited to, pre-race, race and post-race activities. No refunds. Race will take place rain or shine."

I agree I disagree Signature Full Name- Date

The undersigned parent or legal guardian hereby consents to the applicant's participation and waives & releases all rights & claims as set forth above. Signature (Parent/Legal Guardian)- Date

You will also have to fill out the same form on the day of the event.