Move with PT 5k Online Registration

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Registrant #1

Who are you registering? *

First Name *

Last Name *

Email Address *

Confirm Email *

Create Password *

This will be the password for your RunSignup account.

Confirm Password *

Date of Birth *

Format: mm/dd/yyyy

Used for age group calculations

Gender *

Male Female

Phone *

Valid formats include: 000-000-0000 or 0000000000

Street Address *

Country *

Zip Code *

City *

State *

Choose Your Event *

In-Person Event

5k Run/Walk

$30.00 + $3.55 SignUp Fee

(Group Pricing)

Virtual Event

Virtual 5k Run/Walk

$20.00 + $2.95 SignUp Fee

(Group Pricing)

Waiver

In consideration for permission and support by the University of Dayton for me to participate in Move with PT 5k on April 15, 2023 at 10:00am.
I, the undersigned, for myself, my heirs, executors, administrators, and assigns do hereby release, hold harmless, indemnify, waive, and
discharge the University and all its officers, agents, and employees from and against any and all claims, demands, actions or cause of action
arising from any injuries or damage I may suffer or sustain by my participation in this activity. Furthermore, in full recognition and
appreciation of the potential dangers and hazards in such an activity, surrounding my participation in this activity or any activities undertaken
in addition thereto, I hereby assume any and all risks, liabilities, and responsibilities for all accidents, injuries, damages, or property losses
arising from or related to my participation. The undersigned acknowledges having read and understood the foregoing informed consent form.
I have caused this release to be executed with the completion of my registration.

By checking this box, I agree to the waiver and that I am 18 or older, or that I have the authority to register these participants and agree to the waiver for them, and agree to the Privacy Policy.

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Move with PT 5k

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Waiver

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