Step 1 of 4 (Registration Agreement)

Four for the Fourth - 10th Annual

Sunday, July 4, 2021 in Yorktown, IN at Morrow's Meadow

4 Mile Race Walk (no running allowed)
Guaranteed shirt deadline is midnight, June 20th.
$25.00 registration

Waiver

I hereby release the Town of Yorktown and Yorktown Chamber of Commerce and all municipal agencies whose property and/or personnel are used and other sponsoring or co-sponsoring company(ies), or individual(s) from responsibility or any injuries or damages I may suffer as a result of my participation in the 2020 Four for the Fourth Run/Walk and/or related events. I hereby certify that I am in good condition and able to safely compete in this event. I additionally permit the use of my name and image in broadcasts, telecasts, newspapers, brochures, etc. I also understand that the entry fee is nonrefundable. I certify that all information provided in this form is true and complete. I have read the entry information provided for the event and certify my compliance by signature below. Bib numbers are non-transferable. NO REFUNDS. IF PARTICIPANT IS UNDER AGE 18: This certifies that my child has my permission to compete in the Run/Walk, is in good physical condition, and that race officials have my permission to authorize emergency treatment if necessary. I hereby give you my permission to have photos of myself or my child taken during this event for promotional purposes.

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.

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Multiple signers should separate their signatures with commas.

This agreement was generated at 8:45:45 PM EDT on 06/15/2021.

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You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 8:45:45 PM EDT on 06/15/2021

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