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Jane Neely 5K Run/Walk Registration Tuesday, July 4th

  1. Gender*

    Please select one

  2. Select Event Option*

    Please select one

  3. Select Shirt Size*

    Shirts are guaranteed if registered prior to June 19

  4. In the consideration of the acceptance of the application, I, for myself, my heirs, executors and assigns, release, remise, and discharge the sponsors of this race: Shaler Township, Shaler North Hills Library, Kiwanis Park/Crawford Pool, and their representatives from the claims and actions for damages or injuries which I might suffer as a result of this race. I hereby certify that I am physically fit and have trained sufficiently for this race. I also consent to the use of any photos that may involve myself for this publication.

  5. Release Agreement*

  6. Parental Consent*

    Parental Consent is required for particpants under 18. By selecting this box, a parent or guardian has authorized this registration

  7. Leave This Blank:

  8. This field is not part of the form submission.