PRTC Stop, Drop, and Glow Run

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Team name   First name   Last name   Email address   Gender -- Male Female   Phone #   Address   Emergency contact name   Emergency phone #   Age Division Choose one 19-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70 and over Elementary High School Middle School   Event entry fee TBD

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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 understand that participation in this event is strictly voluntary and in consideration of the acceptance of my entry, I, myself, my heirs, executors, and administrators, do hereby release and discharge forever Jackson County High School, volunteers, parents, and all sponsors and their representatives and successors from any and all claims and/or liabilities of any kind arising from my participation in said event including but not limited to injury, death, contact with road, contact with motor vehicles, contact with other participants, hazards of weather conditions, and other potential hazards. I hereby release all publication rights of any photographs or video taken at this event for print and Website publication and/or advertising and social media. By signing below, I indicate that I agree to abide by this agreement and acknowledge that I ASSUME ALL RISK ASSOCIATED WITH PARTICIPATING IN THIS EVENT. I accept the terms of the waiver