Step 1 of 4 (Registration Agreement)

Glow 'N Go 5K

Saturday, September 29, 2018 in Omaha, NE at Stinson Park 67th and Center St.

  • 5K Run/Walk
    Choose your division on step 2
    Register by September 20 to be guaranteed a shirt!

* Click here for fee information

Waiver and Release

This Accident Waiver and Release of Liability must be signed in consideration of my registration and participation in this event. I hereby do:
(A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me or my traveling to and from this event, the Society of St. Vincent de Paul, their directors, officers, employees, volunteers, representatives and agents, event holders, event sponsors, event directors and volunteers;
(B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals and entities as a result of any of my actions during this event. I am aware the Society of St. Vincent de Paul does not provide health and accident coverage for me and it is my responsibility to pay any medical bills from injuries sustained while participating in the Society of St. Vincent de Paul, Omaha

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and / or illness during this event.

Photo Release:
I understand that I may be photographed. I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors organizations and assigns.

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

Multiple signers should separate their signatures with commas.

This agreement was generated at 7:24:14 PM EDT on 09/24/2018.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 7:24:14 PM EDT on 09/24/2018

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