Itasca County Fairgrounds

$18 Registration Fee

Last Name:

First Name:

Phone #:

Email address: 

Gender: M F

Age on Race Day:

Shirt size:
(shirt guaranteed only if registered prior to March 31)

Team name if running as a team ___________
10k run / 5k run (circle one)

Release: I understand that running a road race is a potentially hazardous activity. I enter and participate in this event certifying that I am medically able and properly trained. I also know that although police protection will be provided, there may be traffic on or near the course route. I assume the risk of running
and walking in traffic. I also assume any and all other risks associated with participating in this event, including, but not limited to , falls, contact with other participants, volunteers, spectators, and traffic, the effects of weather, including wind, rain and hail, lightning, high heat and/or humidity, cold and the
condition of the course. Knowing these facts, I hereby for myself, my heirs, executors, administrators, personal representatives or anyone else who might
claim on my behalf, covenant not to sue, and waive, release and discharge the Step Ahead event and any other organization associated with the event,
including the police, and volunteers, including the agents, employees, assigns or anyone acting for or on behalf of any of them, from any and all claims or liability for death, personal injury, or property damage, or any kind or nature, arising out of, or in the course of, my participation in this event, whether
foreseen, or unforeseen, known or unknown. I also understand and agree that this organization or event may subsequently use for publicity and/or
promotional purposes my name and/or photographs of me participating in this event without obligation or liability to me. I understand that entry fees I
pay are not refundable. I have read the forgoing and certify my agreement by my signature below.

Signature: _______________________________(Parent's if under 18)