Summit Hill Recreation Commission: Stay-At-Home 5K Registration Form
May 27, 2018
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Email used to pay with pay pal (if different from above email)
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Address *
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Date of Birth *
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WAIVER APPROVAL (ALL ENTRANTS MUST SIGN) In consideration of the acceptance of my entry, I, intending to be legally bound, do hereby, for myself, my heirs, my executors, and administrators, waive, release and discharge any and all rights and claims which I may have, or which may hereafter accrue to me against the Panther Valley Running and Fitness Club and the Borough of Summit Hill, and any and all agents, sponsors, and promoters for any injuries or illnesses suffered by me while participating in and traveling to and from this event.
My electronic signature below verifies that I have read and understand the waiver approval.
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Parent's electronic signature if participant is under 18 years of age.
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