*Due to the waiver and Credit Card security, you must complete the above steps for each entrant.
*There is a $1 credit card processing fee for online entrants.

First Name:      Last Name: 

Address:           

City:   State:    Zip:  

Email:   Phone No.     

Sex:         ? Female Male       Age: (day of race)       Shirt Size:   ? Small Medium Large XLarge

Emergency Contact and #:    

Waiver:   I agree that by participating in the Run for Spaghetti 5K run/walk or by using any event facility premises, I do so at my own risk.  I assume all risk of injury, illness, damage or loss to me or my property that might result, including without limitation, any loss or theft of personal property.  I consent to medical treatment in the event of injury, accident and/or illness during the event.  I agree on behalf of myself (and my personal representatives, heirs, executors, administrators, agents and assigns) to release and discharge Lower Lights Christian Health Center, Columbus Running Company and any other race sponsors from any and all claims or causes of action (known or unknown) arising out of their negligence.  I acknowledge that I have carefully read the Waiver and Release and fully understand that it is a release of liability.  By my signature below, I am waiving any right that I may have to bring legal action to assert a claim against any and all event sponsors for their negligence.  I hereby grant full permission to any and all the foregoing to use my name and likeness in any broadcast, telecast, and video or print media of the event without compensation.                                       

By selected "I Agree" below, you are authorizing your signature to be taken electronically, which holds the same value as your written signature.

Waiver Signature:                         I Disagree I AGREE