Cinco De Drinko 2019

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Team name   First name   Last name   Email address   Age on event date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 Gender -- Male Female   Emergency contact name   Emergency phone #   City   Distance Choose one 1 mile fun walk 5 km run   Category Choose one Fun walk Choose one 20-29 30-39 40-49 50-59 60-69   Event entry fee 45.00 USD

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Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver I certify that I am 21 years of age to participate in this event Cinco De Drinko 19. I know that running or [volunteering for] a road race is potentially hazardous activity, which could cause injury or death. I will not enter and participate unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I agree to abide by any decision of a race official relative to any aspect of my participation in this event, including the right of any official to deny or suspend my participation for any reason whatsoever. I attest that I have read the rules of the race and agree to abide by them. I assume all risks associated with running in this event, including but no 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 [potential street issues with officers or volunteers] “the heat in July, trail running, rocks all such risks being known and appreciated by me. I understand that bicycles, skateboards, baby joggers, roller skates or roller blades, animals, and personal music players are not allowed in the race and I will abide by all race rules. Having read this waiver and knowing these facts and inconsideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Kelly Valente, event director, the event Cinco De Drinko, and Run Amuck Timing LLC, the city of Haddonfield, Cherry Hill and surrounding area, and the Run Amuck Timing LLC, all event sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. Signature: Date: Date: I accept the terms of the waiver Please enter your name here Proceed to confirmation page Proceed I must be 21 to accept the terms of the waiver Name of parent or guardian who approves this activity Please enter your name here