LMVSC 5K & 1 Mile Fun Run

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Team name   First name   Last name   Email address   Phone #   Emergency contact name   Emergency phone #   Distance Choose one 0.0 (making a donation) 1 mile 5k   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 Medical Release - 5k Run and 1 Mile Fun Run I hereby give my full permission for myself and/or my child to participate in the LMVSC 5K and 1 Mile Fun Run and absolve the Lee Mt. Vernon Sports Club (LMVSC), its officials and coaches of any liability for injuries to myself or my child arising out of participation, including activities necessary or incidental thereto, sanctioned by LMVSC. In the event of injury and my absence, I authorize the person in charge of my child’s team to seek medical care for which I will pay. I understand that the LMVSC does not provide accident or liability insurance for any participant. I agree to abide by LMVSC league rules and policies and always to display good sportsmanship, required of players, coaches and parents at all times. Photo Release Agreement I hereby give permission without restrictions to the Lee Mt. Vernon Sports Club and the County Department of Parks, Recreation and Cultural Resources (PRCR) and its assignees to photograph, film or videotape my player and my family during participation in Lee Mt. Vernon Sports Club and PRCR activities/programs and use of PRCR facilities. Photographs may be used to promote Lee Mt. Vernon Sports Club and PRCR activities. I accept the terms of the waiver Name of parent or guardian who approves this activity Please enter your name here