Register For
The Dustin Deckard Memorial 5k Run & 1 Mile Walk

Pennsville, NJ 08070

Registrant #1

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$25.00 + $2.50 SignUp Fee

$20.00 + $2.20 SignUp Fee


Waiver

waiver: I, the undersigned acknowledge that a race is a hazardous activity. I certify that I am medically able and have sufficiently trained for this event. With the acceptance of my entry I do hereby for myself, and anyone entitled to act on my behalf, waive any liability against the Dustin Deckard Scholarship Fund officials, its volunteers, TNT Event Management, Riverview Beach Park and any and all sponsors and their agents, employees, representatives, for any injuries suffered by me in this event. I also give permission for any photos to be used from this event.
_________________________________ __________
Signature Date
Signature of parent (if minor)




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