5k Run/Walk to benefit the Nancy Heckert Memorial Scholarship Fund
Saturday, May 26th - Penfield, NY

Registration Form

Parent Name Required if Under 18

Please Read
In consideration for being accepted by Southeast Christian Academy for participation in the Race for Nancy 5k, I, being 18 years of age or older, do for myself (and if under 18, I, the parent, on behalf of my child, hereby release, forever discharge, and agree to hold harmless Southeast Christian Academy and Southeast Bible Baptist Church & Commonground Baptist Ministries and its officers, agents, employees, representatives, executors, and the directors thereof, from any and all liability, claims or demands for personal injury, sickness, or death, as well as property damage and expenses, of any nature whatsoever, which may be incurred by the above signed participant, that may occur while said child is participating in the above described activity. Furthermore, (and if under 18, I, the parent, on behalf of my child, do...) hereby assume all risk of personal injury,sickness, death, or damage as a result of participation in recreational and work activities therein and described above. The above signed participant or undersigned parent/guardian further hereby agree to indemnify and hold harmless said ministry, its directors, employees and agents, for any liability sustained by said ministry as the result of the negligent, willful, or intentional acts of said participant. If the participant has not attained that age of 18 years: We (I) are (am) the parents (parent) or legal guardians (guardian) of this participant, and hereby grant our (my) permission for him or her to participate fully in said activity, and hereby give our (my) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, and assume the responsibility of all medical bills, if any.