T-Shirt Size:  Medium  Extra Large

Participant’s Signature
By adding my name to this form, I wave and release any and all rights and claims for damages I may have aginst any of the sponsors, organizers, Holy Cross Lutheran Church, City of Lawrence, The Sharing Place, for any and all claims of damages, demands or loss actions whatsoever which may arise as a result of my participation in this event. I understand and acknowledge that participating in this run/walk event may expose me to dangers from both known and anticipated risks. I attest and verify that I am physically fit and have sufficiently trained for the completion of this event and my physical condition has been verified by a licensed medical doctor. Further, I grant full permission to any and all of the foregoing to use my likeness for any legitimate purpose whatsoever.

Participant’s Name:
Date:

Parent’s or Guardian’s Name if participant is under 18 years of age:

Date: