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The 5th Annual
D.A.R.E. CLASSIC 5K

JUNE 19, 2010


OUR SPONSORS:
 


 

Registration Form

First Name:    Last Name: 

Street: 

    City:           State:             Zip:

Phone:        E-mail: 

M/F:         Date Of Birth:             Age on 6/19/10: 

Shirt Size: 

       Event: 

By clicking "Accept," you agree to the following:
 
In consideration for accepting this entry & the granting of the right to participate in this event, I, intending to be legally bound, hereby, for myself, my heirs, personal representatives, successors, & assigns, waive & release any & all claims for losses & damages I may have against Berkeley Township, all volunteers, all sponsors, all their representatives, successors, & assigns, &/or other persons whomsoever for any & all injuries, illness, including death, that may result from my participation in said event.  I represent & affirm that I am in good physical condition to participate in this event, & verified by a licensed physician, & have sufficiently trained for the completion of this event.  I grant to all foregoing, the right to use any photographs, recordings, or any other record of this event for legitimate purposes.

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© Berkeley D.A.R.E. 2010