Step 1 of 4 (Registration Agreement)

Pumpkin Dash
Presented by Cornbelt Running Club & Running Wild

Sunday, October 24, 2021 in Davenport, IA at Credit Island Park

  • 8K
    CBRC Members will receive $1 off on Step 2.

  • 4K
    CBRC Members will receive $1 off on Step 2.

  • 1/4 Mile Children's Costume Race
    (ages 7 & under)

  • 1/2 Mile Children's Race
    (ages 8 to 13)

  • Family Entry
    Register 2-4 family members from the same household in a single transaction

* Click here for fee information

Event Waiver and Release Form

I understand there are inherent risks in participating in any road race. In consideration of the acceptance of my entry, I, for myself, my executors, administrators and assignees, do hereby release, Cornbelt Running Club. City of Davenport, The Davenport Parks and Recreation Board , Running Wild, and all sponsors, their representatives and successors for all claims and damages, demands, actions, whatsoever in any manner arising or growing out of my participation in the Events of the Pumpkin Dash. I attest and Verify that I have full knowledge of the risks involved in this event; I 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 5:52:10 AM EDT on 10/19/2021.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 5:52:10 AM EDT on 10/19/2021

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