ST. ROSE FAMILY DAY & 5K
Senior Registration Form
Ages 65 and Over are FREE!
All participants receive a T-Shirt.
Emergency Contact Information
Name and Telephone number
Would you like to serve as a Volunteer?
Please enter me in the Saint Rose of Lima 5K. I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
Acknowledge Waiver & Register
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