Step 1 of 4 (Registration Agreement)

Nick Teddy 5K

Saturday, September 18, 2021 in Port Byron, IL at Main Street and Great River Trail

  • 5K
    Entrance to the after party included with registration.

* Click here for fee information


In consideration of your acceptance of my entry, I hereby for myself, my heirs, executors and assigns, waive and release any and all rights and claims for damages against the Nick Teddy Foundation, Quad City Sole Sisters, Village of Port Byron, sponsors, officials,
volunteers and workers for any injury or accident suffered by me in connection with the Nick Teddy 5k on September 18, 2021.

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 9:51:18 AM EDT on 06/12/2021.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 9:51:18 AM EDT on 06/12/2021

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