Click here to Register On-LineOR PRINT THIS FORM & MAIL WITH YOUR CHECK PAYABLE TO: CURE PD, P O BOX 18, EARLINGTON PA 18918 For info: www.curepd.info (215) 721-7820
Registration Amount: $ ______5K race/walk $ ______ Kids Fun Loop
CURE PD 5K RACE/WALK TO BENEFIT PARKINSON'S DISEASE
SATURDAY, May 17, 2008
First Name:_____________________ Last Name: ____________________
Birthday: _________________ Age on Race Day: ____________________
Gender (circle one): Male Female
To Participate: Cure PD 5K Race/Walk will begin and end at Franconia Park, Godshall Road, Franconia, PA. Parking will be permitted on the Allentown Road side of the park only.
Registration Fees/Schedule: 8am - 9:15 am - 5K Race or Walk: $20 (per person) $18 if you register before 5/15 10:30am - 11:00am - Kids Fun Loop: $5 (per child) 11:00am: Awards Ceremony
Prizes: T shirt to first 200 registered participants. Cash prizes to overall first & second place male & female winners. Other prizes will be awarded in each of the age groups.
I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all the risks associated with running this event including but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of you accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Cure PD and all those involved in organizing this event, the township of Franconia, the Michael J. Fox Foundation, and all sponsors, their representatives and successors from all claims of liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence of carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recording, or any other record of this event for any legitimate purpose.
SIGNATURE: _______________________________________________________ Parent's signature required for participants less than 18 years old
