2019 Road Race for the Animals 5K Registration
Registration for the 2019 Road Race for the Animals 5K, benefiting the Wildlife Medical Clinic and the K9 Officers Down Fund at the University of Illinois Veterinary Teaching Hospital. Registration this year is $25.
Name (Last, First) *
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Mailing Address *
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E-mail Address *
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Please choose one
Which race are you participating in? *
Age *
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T-Shirt Size *
If you are bringing a pet racing partner, please list their name and species below
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Registration Fee: Registration will be $25 dollars. Please note how you would like to pay for registration. In order to guarantee a T-shirt for racers, registration needs to be paid for/post-marked by February 1st, 2019. *
Name on Paypal Account/Check paying for registration (Multiple entries can be paid at once or additional donations can be made):
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I have agreed to the following waiver: Omega Tau Sigma Theta Chapter Accident Waiver and Release of Liability Form. I hereby assume all of the risks of participating in the Road Race for Animals, a charitable activity sanctioned by Omega Tau Sigma. I understand that my participation in this event is optional and done at my own discretion. I certify that my animal is of sound health, on appropriate parasite prevention, and current on all vaccinations (in compliance with local, state, and federal laws pertinent to animal vaccination protocols and as exemplified by the attached copy of an official, up-to-date Rabies record). I certify that there are no health-related reasons or behavior problems which should preclude my pet from participation in this activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of this activity in which I may participate, and that it will govern my actions and responsibilities at said activity. I hereby take action for myself and my animal as follows: (A) I waive, release, and discharge from any and all liability (including liability brought about through injury to my animal or to other human beings by my animal) Omega Tau Sigma Theta Chapter, Theta Club Inc., Omega Tau Sigma Nationals, University of Illinois Urbana-Champaign, Illinois College of Veterinary Medicine, and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers. (B) I forever indemnify, waive, release, hold harmless, discharge, and covenant not to sue the entities and persons mentioned in the above paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that the above entities and their directors, officers, volunteers, representatives, and agents are not responsible for the errors, omissions, acts, or failures to act that may occur during the course of the activity. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I certify that I have read this document and I fully understand its content. I am aware that this is a release of liability and a contract and I sign it of my own free will. *
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