Register For
Walking for Amy

Roanoke, IL 61561

Registrant #1

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$25.00 + $2.50 SignUp Fee

$25.00 + $2.50 SignUp Fee

$25.00 + $2.50 SignUp Fee

Event Preview

$35.00 + $3.10 SignUp Fee

$35.00 + $3.10 SignUp Fee


Waiver

For in consideration of my participation in the Walking for Amy Event (Walk, Run, Kids Fun Run), I hereby for myself,
my heirs, administrators, and assigns, release and discharge the Village of Roanoke, Roanoke Park, St. Jude
Children’s Research Hospital in Memphis, TN, St. Jude Runners Association, and St. Jude Midwest Affiliate in Peoria,
IL, the Schwind family and those in charge of the events, and all involved sponsors and their respective servants,
agents, employees, officials, and officers, from any and all claims, demands, liabilities, loss, damage, and causes of
action of any sort, including attorney’s fees for injuries, sustained to my person and/or property incurred by reason of
my participation or preparation for the above said event due to negligence or any fault. I certify that my participation in
this event is free and voluntary. I have read and understand the foregoing Release and Waiver.




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