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Last Name
First Name
Address
City
State
Zip
Phone
- -
Email
Age on raceday
Gender
Which Event?
Kids Run
I have kids who will participate in the free kids run
How many kids?
T- Shirt - $10
Do you want one?
Size

 

Waiver
In consideration of my participation in the Quest for Nets 5K Run, I the undersigned, my heirs, executors and administrators consent to discharge, release and hold harmless Quest United Methodist Church, the Urbana Park District, the City of Urbana, Second Wind Running Club, race sponsors, workers and their affiliates, agents, employees, successors and distributors for claims, action, losses, damages or expenses for personal or bodily damage and property loss or damage incurred by me arising out of or in connection with my participation in this event. I hereby grant permission to the parties listed herein to use my name and photographs, videotapes, motion pictures, recordings or any other record of my participation in this event for any purpose. Lastly, I understand that bicycles and roller blades/skates are NOT allowed in the race at any time. I have read the foregoing and am of legal age to consent to the waiver and have trained to the best of my ability for this event.
I agree to these terms (check here)

 

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