5K Registration & Waiver
For the White City Community Council Annual 5K 
Full Name *
Email *
Address *
City *
State *
Zip/Postal Code *
Date of Birth *
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Phone number *
Emergency Contact - Name *
Emergency Contact - Phone *
Emergency Contact - Relationship to Participant *
Participant Agreement:

I, the undersigned participant, acknowledge that my participation in the White City Community Council 5K event involves certain risks and dangers, including but not limited to the risk of personal injury, illness, property damage, or even death. I voluntarily assume all risks associated with participation in this event.

By signing below, I hereby release, waive, discharge, and covenant not to sue the White City Community Council, its officers, directors, employees, volunteers, sponsors, contractors, and agents from any and all liability, claims, demands, actions, or rights of action arising out of or related to my participation in the 5K event.

I certify that I am physically fit, have sufficiently trained for participation in the 5K event, and have not been advised otherwise by a qualified medical professional.

I grant permission to the White City Community Council and its authorized representatives to use my name, photograph, voice, and likeness in any promotional materials, advertisements, or media coverage related to the 5K event, without compensation or further notice.

Participant Signature *
Today's Date *
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Parent or Guardians Signature (if participant is under 18 years old)
Today's Date
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