2012 Philadelphia World Water Day Walk-a-Thon / 5K Run

T-Shirt Size: Select One S M L XL XXL

Registration Fee (Check One:) $20 Student (ages 13-25) $30 Adult (ages 25-60)  $10 Senior (age 60-?)

WAIVER:  I understand that running/walking a road race is a potentially hazardous activity.  By my signature, I attest that I am physically able, medically cleared and/or properly trained to participate in this event and as such, assume all responsibility/risk associated with my participation.  I, along with my heirs, executors, administrators and/or anyone else who might claim on my behalf, hereby covenant not to sue and waive, release and discharge Keiyo Soy Ministries, all owners of the properties on which the race is be run, all municipalities in which the event is held, all volunteers, committee members, and all other organizations directly and/or indirectly associated with the event, sponsors including their agents, employees, assigns, or anyone acting on their behalf, from all claims or liability for death, personal injury or property of any nature arising out of, or in the course of my participation in this event.  This waiver extends to claims to any/all claims of any kind.  In addition, by signing this release, I grant KSM and parties affiliated with this event to use pictures and any likeness of me secured at the event as is appropriate, without review, restriction and/or compensation. 

I HAVE READ AND UNDERSTAND THIS WAIVER

Checking this box serves as your official signature and signifies that you have read and understand the waiver.