Upcounty Community Resources Registration

August 29 - Sept. 7

Participant $35

Participant Name *

First

Last

PARTICIPANT Emergency Contact Name *

PARTICIPANT Emergency Contact Number *

PARTICIPANT T-SHIRT SIZE *

Waiver & liability by registering for these UCR programs I am admitting I am fully aware of the risks and hazards connected to physical activity. I hereby release, waive, discharge and covenant not to sue Upcounty Community Resources, Inc, their officers, employees, volunteers or assistants from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any injury that may be sustained by me or my charge while taking part in the UCR 5K. *

I agree.

I agree to receiving marketing and promotional materials

Submit & Continue

August 29 - Sept. 7

Participant $35

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