Brayden's Trail Of Strength

                                                                            Online Registration


10K Trail Run/Hike

WHEN:     Saturday, August 03, 2024
                Start Time:  9:30 am
ENTRY FEE:  $25.00          
    **Please make checks out to the Chromosome18 Registry & Research Society c/o Susan Blackwell**
AWARDS: Finishers will receive a Finishers Medallion. Awards to first male & female overall finishers.
T-SHIRTS: All pre-registered entrants will receive a free t-shirt. First come, first serve until T-Shirts are gone on event       day!                                                                                                                                                                                           
WHERE:  110 Confer Lane, Wellsboro, Pa 16901
              (Follow signs off of Route 6 onto Marsh Creek Rd. in Ansonia. We are located 8 miles West of Wellsboro)
WHY:       Proceeds to benefit the CHROMOSOME 18 REGISTRY & RESEARCH SOCIETY in honor of Brayden Blackwell
REGISTRATION: Saturday, August 03, 2024 from 8:00 am to 9:15 am.
First Name:_____________________________ Last Name: _________________________________

Address: ______________________________________________________     State: _____________

Zip Code: ____________ Age (on race day): __________ Gender (circle): Male or Female
Phone: _______________________          Email: _____________________________________
T-Shirt (Please Circle Size):      S      M      L      XL    2XL
Liability Waiver:                                                                                                                         

  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 indemnity 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 the form. ALL UNSIGNED ENTRIES WILL BE RETURNED.

_________________________________               ____________________________________              ________________________

         Signature                                                                  Signature of Parent(If under age 18)                                           Date
                                                                                                                Mail to:
                                                                                                        Susan Blackwell  
                                                                                                        110 Confer Lane
                                                                                                        Wellsboro, Pa 16901