COMPLETE REGISTRATION HERE

Complete this form then pay below.

10 dollar race

Race Registration

$10

Please Complete Form on the Top of the Page

To Registration for this year’s race, please fill out the form at the top of the page and be sure to send us your name, address, age, phone number and Email address using our secure server. (Please note that this is for the race only, no t-shirt will be provided with this option.)

 
glow in the dark event shirt

Registration with Glow-In-The-Dark Event T-Shirt

$25

Please Complete Form on the Top of the Page

*Those who registered after August 12th (and bought the t-shirt package) will receive their t-shirt when the event is completed. Please be sure to provide an email address if you are not choosing to have your t-shirt mailed so that a pick-up date can be conveyed when scheduled.*  

To Registration for this year’s race, please fill out the form at the bottom of the page and be sure to send us your name, address, age, phone number and Email address using our secure server.  

Need Shipping?

$25 + $5 Shipping

Please Complete Form on the Top of the Page

 Do you need your t-shirt shipped to you? Be sure when you fill out the registration below you add that you paid for the shipping!  There will be a pick-up date for t-shirts in Norwich, NY in August of 2020. **An email will be sent when the shirts are in and a pick-up date is scheduled.  Pick-up will be in West Park in Norwich.**

memorial wall

Write on the Memory Wall

$10

Add a name or message to the memory wall. Once you make your payment email the name and/or message you want to be added to the wall to chenengohealthandwellness@gmail.com 

By Registering for this event it means you are agreeing to the terms of the waiver below

Chenango’s Recovery and Wellness

5K Glow Run/Walk 2020

Registration, Waiver and Release of Liability for Participants 

*** By registering for this event, you are agreeing to the terms outlined in the waiver. ***

WAIVER: 

In consideration of being permitted to participate in Chenango’s Recovery and Wellness Glow 5K Walk/Run I agree to assume all risks inherent in participation in this event, whether they are apparent to me or not.  I certify that I am in good physical health and fit to participate.  Nevertheless, I acknowledge that participation carries an inherent risk of injury to my person and damage to my property.  I hereby waive and release, for myself and for my heirs and assigns, any and all claims, causes of action, or liabilities which may hereafter accrue against, Chenango’s Recovery and Wellness Glow 5K Walk/Run and its affiliates, their agents, employees, volunteers, officers, directors, successors, that may arise as a result of my participation in Chenango’s Recovery and Wellness Glow 5K Walk/Run, including any and all claims for personal injuries caused by Chenango’s Recovery and Wellness Glow 5K Walk/Run negligence. 

Further, I hereby grant full permission to any and all of the foregoing to use any photographs, motion pictures, recordings, or any other record of these events for any legitimate purpose, including commercial advertising, without monetary payment to me. (This information is protected by the Privacy Act). 

This section to be read by parent/legal guardian if Participant is a minor: 

As the parent/legal guardian of the above-named Participant, I hereby waive and release on behalf of my child, any and all claims, and causes of action, or liabilities which may hereafter accrue against Chenango’s Recovery and Wellness Glow 5K Walk/Run and its affiliates, their agents, employees, volunteers, officers, directors, successors and assigns, and any and all sponsors, their representatives and successors, by reason of my child’s participation in said program, including any and all claims for personal injuries caused by Chenango’s Recovery and Wellness Glow 5K Walk/Run negligence.  In addition, I accept full responsibility for the care and supervision of my child during the above-described event. 

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