10K and 23K Trail Run/Hike

BRAYDEN'S TRAIL OF STRENGTH

10k and 23k Trail Run/Hike

When: Saturday, August 05, 2017

Start Time: 8:45 am

Where: 110 Confer Lane, Wellsboro Pa 16901

(Follow signs off of Rt. 6 onto Marsh Creek Rd. in Ansonia. We are located 8 miles West of Wellsboro)

Fee: 10k → $25.00 23k → $35.00

**Checks Payable to: Chromosome18 Registry & Research Society

EARLY BIRD SPECIAL! SAVE $5by registering on or before July 1, 2017

Awards: Finishers will receive a finishers medallion. Awards to first male & female in the

10k and 23k events!

Tshirts: All pre-registered entrants will receive a free Tshirt. First come, first serve until

Tshirts are gone on event day!

Why: Proceeds to benefit the CHROMOSOME18 REGISTRY & RESEARCH SOCIETY

Registration & Packet pick up: Saturday, August 05, 2017 from 7:00 am to 8:30 am.

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ENTRY FORM Mail to:

Susan Blackwell

110 Confer Lane

NAME:______ Wellsboro, Pa 16901

ADDRESS:______

Phone:______Age:______Gender:_____ 10k_____ 23k_____

T-SHIRT (Please circle) S M L XL e-mail: ______

In consideration of the opportunity to enter this event, I, for myself, my heirs, executors, administrations and assigns, hereby, waive, release and forever discharge any and all claims for damages, for death, personal injury, and loss of property I may have or which may occur to me as a result of my participation. I discharge and release the Department Of Conservation and Natural Resources , Commonwealth Of PA, Shippen Township, private property owners, emergency personnel, volunteer physicians, the event, organizers, and its respective agents, committees, and any other involved employees, and representatives from liability arising out of or connected in any way with my participation in Brayden's Trail Of Strength. Whether or not caused by the negligence of any of the above parties.

I acknowledge that there are inherent risks and dangers that may arise at any time during this event. My participation is voluntary and is done at my own risk. I attest that I am physically fit and sufficiently trained for the completion of this event. I understand that serious accidents occasionally occur during hike/run events, and the participants in Brayden's Trail Of Strength may sustain mortal or serious injury as a consequence thereof. Nevertheless, I agree to assume those risks and to release and hold harmless all persons mentioned above who might otherwise be liable to me (or my heirs of assigns) for damages, of whatever kind of nature. I agree to abide by the rules of this event as established by the organizing committee and to obey the directions of the event officials. I hereby grant full permission to the event organizers, committee(s), volunteers, and any other involved parties to use photographs, video tapes, or any other record of this event, including my name, likeness, for any legitimate purpose. I have read, understand, and agree to the liability waiver on this form. ALL UNSIGNED ENTRIES WILL BE RETURNED.

______

Signature of Participant Signature of Parent Date

(If under 18)

ONLINE REGISTRATION