Howard County Medical Center's Jack O' Lantern Jog

Saturday, October 19, 2024 at Howard County Medical Center (East Parking Lot) in Saint Paul, NE

What category would you like to sign up for? You can sign up for any of the following categories.




Waiver

In consideration for the acceptance of my entry, I do hereby for myself, minor children, executors, administrators, and assignees, do hearby release Howard County Medical Center and any other contributing sponsors and supporters of this event and their respective officers, members, agents, volunteers, and employees from all claims arising out of my participation in this event.

I attest and verify that I have knowledge of risks involved in this event and am physically fit and sufficiently trained to participate in this event. I give permission for current and future use of my name and picture in any broadcast or print media account of the event. I understand that the entry fees are non-refundable.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

  • I have read, have understood, and do accept the agreement above.
  • I understand that this is a legal document with effects that I approve and authorize.
  • The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
  • I am authorized to agree to the terms of this document on behalf of the registrant.
  • If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

Electronic Signature

You must be 18 years of age to legally complete this registration. If the registrant is under 18, an authorized adult must complete this form.
If the person you are registering (registrant) is under 18, do not enter his/her age. You will do that on the next step. Enter your age here as the person completing the form.




Multiple signers should separate their signatures with commas.


This agreement was generated at 9:19:02 PM EDT on 09/28/2024.