Step 1 of 4 (Registration Agreement)

Gilda's Run for Laughs-VIRTUAL RUN!

Presented by UnityPoint Health - Trinity

Saturday, April 25, 2020

    Shirts are not guaranteed for entries received after April 16th

* Click here for fee information

Event Waiver and Release Form

In consideration of the acceptance of my entry, I for myself, my executors, administrators, and assigners, do hereby release and discharge Gilda’s Club, City of Rock Island, any sponsors, supporters, or volunteers, for all claims and damages, demands, actions whatsoever in any manner arising from participation in the Gilda’s Run 5K/1 Mile Run or Walk. I attest and verify that I have full knowledge of the risks involved in this event, am physically fit, and sufficiently trained to participate in this event.

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 2:59:03 AM EDT on 03/31/2020.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 2:59:03 AM EDT on 03/31/2020

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