Register For
AXA Man on the Run 5K

Warwick, 0000

Registrant #1

Who are you registering? *


By selecting this box, you are indicating that you are the parent/guardian of the person you are about to register. Additionally, if the child is under the age of 13, you are consenting to the collection and use of the information about the child for the purpose of the registration as described in our privacy policy.

Have An Account?

Basic Info

To be able to access / edit your registration.

Additional Information

Format: mm/dd/yyyy
Used for age group calculations
Format: ###-###-####

Address

Choose Your Event(s) *

$35.00 Event Fee + $3.00 SignUp Fee
Open to ages 10+.
$15.00 Event Fee + $3.00 SignUp Fee
Open to ages 7 - 10.
$35.00 Event Fee + $3.00 SignUp Fee
Open to ages 10+.
$35.00 Event Fee + $3.00 SignUp Fee
$35.00 Event Fee + $3.00 SignUp Fee

Waiver

I acknowledge that (1) running is a potentially hazardous activity, (2) I should not enter and participate unless I have properly trained, prepared and, I am medically able, (3) I should seek medical advice from my General Physician/doctor if I am in any doubt as to my physical ability to take part in the event, and (4) I have voluntarily chosen to participate. 

I hereby confirm that (1) I am in good health; (2) I have trained and prepared to participate in and complete the event; (3) I am entering this event entirely at my own risk and assume all risks for my health and well being and all risks associated with participating in this event including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. 

I hereby waive, fully release and agree to hold harmless Bermuda Cancer and Health Centre (“BCHC”), Bermuda Timing, AXA XL (and its parent AXA SA), Butterfield & Vallis and their officers, directors, agents, volunteers, employees, all sponsors, representatives, and successors, from any and all claims, demands, damages, costs, expenses, actions, or liabilities of any kind, arising from my participation in the event (whether as spectator, participant, competitor, volunteer or otherwise), whether prior to, during or subsequent to the event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. 

I pledge that ANY AND ALL money raised by myself will be transferred to BCHC. 

I understand that BCHC, Bermuda Timing, and the various volunteers organizing this event will hold and use data provided by me in connection with the above-named event for administration purposes, to keep me informed of its activities and for occasional fundraising appeals.

I hereby consent and grant permission to AXA XL (and its parent AXA SA), BCHC and/or Butterfield & Vallis, its employees, agents, and representatives to:

1)      photograph, video or record my image, likeness, or depiction;

2)      edit, crop photographs, images, videos, or records; and

3)       use photographs, digital images, and/or video or audio recordings including images of me or the participant(s) named above for advertising, promotional, and/or any other legitimate purposes on any medium, including but not limited to social media. 

By checking this box:

1)      I hereby agree that I have read, understood, and agreed to: (i) the acknowledgements, confirmations, consents, and waivers above and (ii) the RunSignup’s Privacy Policy 

2)      I further represent that (i) I am 18 or older, or (ii) I have the authority to register the participants and agree to the waivers for them and agree as participant’s parent or legal guardian, if participant is a minor.




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