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PLEASE NOTE: HATHAWAY BROWN'S CARNIVAL 5K IS A FUNDRAISING EVENT FOR CHARITY. IF THE RACE WERE TO BE CANCELED FOR ANY REASON, NO REFUNDS WILL BE ISSUED.


Race Day Registration Cost: $30

PARTICIPANT INFORMATION

xxx.xxx.xxxx
5K Participants Only
For Divisions
(if applicable)​

RELEASE AND WAIVER

Please: No pets, skateboards or skates (Helping Dogs are permitted)

In consideration for the acceptance of my application to participate in the Hathaway Brown 5K Race/Walk ("the 5K Race") I do hereby fully forever waive, release and discharge for myself, my estate, heirs, executor and assigns, the City of Shaker Heights, Hathaway Brown School and their respective trustees, officers, administrators, employees, agents and volunteers and all other persons and entities involved in the organization, planning or supervision of the 5K race from any claims, losses or damages whatsoever, including any and all personal injuries, damages to health or any other damages arising directly or indirectly from my participation in the race or race-related activities whether said losses, damages or claims are caused directly or indirectly by or related to a known or unknown risk of hazard, and whether they are caused by a negligent act or acts, regardless of the degree of negligence.

I warrant that I am physically fit and sufficiently trained to participate in the race. I further acknowledge that I understand that the race is not a part of the regular school-related curriculum or extracurricular activities of Hathaway Brown School and that my participation in the race and related activities is entirely of my own free will.

I warrant that I have read and understand the contents and meaning of this Release and Waiver and agree to be legally bound by all of its terms and conditions.

TO BE COMPLETED BY PARENTS OF PARTICIPANTS WHO ARE
UNDER 18 YEARS OLD AND/OR MENTALLY DISABLED

All others may skip.

As the responsible parent and natural guardian of the participant, I attest and verify that the participant has my full consent to participate in the race and related activities. I warrant that I am the parent/natural or the duly appointed legal guardian, and I have read and understand the above Release and Waiver. I acknowledge the terms and conditions set forth. The contents and meaning of this Release and Waiver are clearly understood.


PAYMENT


Shaker Heights, Ohio Girls K-12 Coed Early Childhood

19600 North Park Boulevard Shaker Heights, Ohio 44122 P: 216.932.4214
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