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Waddington Homecoming Run Approaching

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WADDINGTON — The 2014 Waddington Homecoming 5K River Run-Walk, Rollerblade will be held on Saturday August 2, 2014 The race begins at 9 a.m. and registration will begin at 7:30 a.m. Participants may pre-register with the form below. The entry fee is $15. Participants should make checks payable to the Waddington Vol. Fire Dept. Mail forms and payments to PO Box 352, Waddington, NY 13694.

For further information call Jason Brown (315)286-0192, or Kevin Sharlow (315)276-9040.

REGISTRATION FORM

Name:___________________________ Sex______Age:_________

Address:_________________City:______________________

State:_______________ Zip:____________________

Email:_____________________Phone:___________________

Shirt Size:  Small  Medium  Large  X-Large Cost: $15 US $15Canadian

Waiver of Liability:

I agree that by participating in the Waddington Vol. Fire Department’s 5K Run, I do so at my own risk. I assume all risk of injury, illness, damage or loss to me or my property that may result, including without limitation, any loss or theft of personal property. I consent to medical treatment in the event of injury, accident and/or illness during the Waddington Vol. Fire Department’s 5K Run and 1 Mile Fun Walk. In exchange for accepting my entry fee, I agree to be legally bound, for myself, my heirs, next of kin, executors, and administrators, and voluntarily assume all risks of accident or injury and release and forever discharge, indemnify and hold harmless the Waddington Vol. Fire Department’s 5K Run, The Waddington Vol. Fire Department, its officers, members, volunteers, and/or sponsors (“Released Parties”) from any and all liability for personal injury or property damage of any kind sustained during the Waddington Vol. Fire Department’s 5K Run and 1 mile Fun Walk whether such personal injury or property damage is caused directly or indirectly by the Released Parties. I have full knowledge of the risks involved and attest that I am physically fit and sufficiently trained to participate in the 5K Run or 1 Mile Fun Walk.

Signature of Runner:_________________________________

Legal Guardian’s Signature: (If participant is under 18 on August 04, 2014):_________________________________________

Emergency Contact: _____________Phone:_______________

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