Register For
Chatham Jaycees Fishawack Run

Chatham, NJ 07928

Registrant #1

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$30.00 + $3.75 SignUp Fee

$30.00 + $3.75 SignUp Fee


Waiver

In consideration of this entry being accepted, I hereby for myself, heirs, executors, and administrators waive and release any claims that I may have against Chatham Borough, Chatham Township, Chatham Jaycees, Chatham Borough First Aid Squad, and all sponsors of the run, or their representatives, successors, or assignees for any injury including but not limited too fractures or failures of any bodily function, resulting either from exertion or the failure to provide adequate or properly administered first aid that may be suffered by me in this event. I also give permission for the use of my name and/or picture in any newspaper, broadcast, telecast, or other account of this event. I certify that I am in physical condition for this event.




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