Register For
Beat The Eagle

Lombard, IL 60148

Registrant #1

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$40.00 $35.00 + $4.16 SignUp Fee

$25.00 $20.00 + $3.26 SignUp Fee


I know that running &/or walking a road is a potentially hazardous activity and that I should not run
or walk in the St. John’s Beat the Eagle 5k run/walk or 1 mile fun run unless I am physically fit, in
good health & properly trained. By signing this waiver I acknowledge these risks and declare and
attest that I am in good health and physically fit. I hereby assume any & all risks associated with
running and walking this event, including but not limited to falls, contact with other participants,
injuries caused or contributed to by the weather conditions, road conditions, vehicular traffic and
all other potential anticipated and unanticipated event conditions.
In consideration of the acceptance of this entry and registration, I hereby for myself, my heirs, my
executors, my administrators & my medical insurers waive any & all claims or rights of action I may
have or assert against St. John’s Lutheran Church, St. John’s Lutheran School, St. John’s PTO, The
Village of Lombard, sponsors, & the organizers of The Beat the Eagle 5K Run/Walk & 1-Mile fun run,
and each of their heirs, representatives, successors and assigns for any and all injuries or other
damages I may suffer or incur in connection with this event, including pre & post-race activities &
By signing this waiver I further grant permission to St. John’s Lutheran Church & School and their
authorized agents to use my name, photographs, videotapes, motion pictures, recordings or any
other record of my participation in this event for any purpose.

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