Good Shepherd Sports 17th Annual 5K Run/Walk Saturday, June 11, 2016 Register: [email protected]

Register by Monday, June 6th @ midnight $25 Register Tuesday, June 7th through Race Day $30 Registration includes Race, After Party and Race Bag (quantities limited)

$5 CHILDREN’S PEE WEE RACE (INCLUDING PARTY)

$5 PARTY ONLY

(please make check payable to Good Shepherd Sports)

WAIVER: I know that running in the Good Shepherd Race is a potentially hazardous activity. I should not enter and run unless I am medically able & properly trained. I assume all risk associated with running in the Good Shepherd Sports Race, included, but not limited to, falls, contacts with other participants, the effect of the weather, including heat and humidity, traffic and the conditions of the road, all such risk being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my application I, for myself and anyone entitled to act on by behalf, waiver and release the Good Shepherd Sports, Good Shepherd Church, SHAC, NYPD, NYC and any and all sponsors and their representatives, supporters and assignees for any and all injuries or liabilities of any kind arising out of my participation in this event though that liability may arise out of negligence or carelessness on the part of the person named in the waiver.

Date______Signature of

Entrant______

Signature of parent if Entrant is under 18 years of age______