2017 Stampede 5k Registration Form (Race Day Sunday July 30 2017 8:00am)
City, State Zip
12 and under
12 and older
Form of Payment? - All checks payable to CFF
Sending $20 in advance to Pam Laurent 200 Hidden Dr Bristol VT 05443
Will bring $25 day of race
Collecting Donations - will bring to event
WAIVER: I, the undersigned, agree to indemnify and hold harmless the Cystic Fibrosis Foundation from all cost, expense and liability arising out of my or my child’s participation in this event to benefit the Cystic Fibrosis Foundation. I hereby waive all claims for damage or loss to my or my child’s person or property which may be caused by any act, or failure to act, by the Cystic Fibrosis, its officers, agents or employees arising directly or indirectly from my or my child’s participation in this event; and I hereby assume liability for any loss, damage or other liability from such event. IMPORTANT: Participants under age 18 must have this form checked by a parent or guardian.
My under 18 child has my permission to participate..please type your name:
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