Peter's Place Foundation Registration

Register Below - Saturday, October 5th 5k Run/Walk

 
* First Name:

* Last Name:

* Address:

* City:

* State:

* Zip:

* Phone:

* Email:

Gender:
 Male
 Female

Age on 10/5/24*:


 No Shirt ($30)
 No Shirt
Participant Type:
 Runner
 Walker
 Non-Participant Donation

Please consider an additional donation:
$

Total Payment Amount:


Disclaimer/Waiver of Liablility

I understand that running/walking a race is a potentially hazardous activity. I know that I should not enter a run/walk unless I am medically able and properly trained. I agree to abide by the decision of any race official relating to my ability to safely complete the race. I assume all risks associated with running/walking this event. Having read this waiver, my checking of the below box verifies that I understand these facts and understand that upon your acceptance of the application, the entry fee is non-refundable. I, myself, and anyone entitled to act on my behalf, waive and release, Peter's Place Foundation, NFP and the city of Fairview Heights, Illinois, and all other persons, sponsors, volunteers, their representatives and successors from all claims or liabilities of any kind arising from my participation in this race. I also understand that some information may be used by the sponsors. I grant permission to all the foregoing to use any photographs, motion pictures, recordings or any other record of this race for any legitimate purpose.

  I have read and agree to these Terms and Conditions.