Viterbo University - The University of Opportunity: Hope and Help

Viterbo University Friar Frolic 5K Run/Walk

9:00 am Saturday, Oct. 11, 2014


REGISTRATION 

Last Name:     First Name:     M.I.:  
Address: 
City:      State:      Zip: 
 

Phone:       Email:  

Class Year if Alumni of VU:   

Gender:  
                                                                                                                                             
Age on 10/11/14:  
 
T-shirt Size:                   Category: 
 
Fees: 
Family Rate $2 discount each for three or more participants in the same immediate family. Each participant is required to fill out a registration form. Submit family registrations together.
 

My additional donation to support the Viterbo Student Food Pantry: 

Total Amount Due: 

   Fees will not be refunded in case of severe weather.
 
WAIVER:  I know that running/walking a road race is a potentially hazardous activity. I assume all risks associated with participating in this event including, but not limited to: falls, contact with other participants or spectators; the effects of the weather including heat, high humidity, cold; traffic; or the conditions of the road surface; all risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act for my behalf, hold harmless and release the City of La Crosse, Viterbo University, and all sponsors of the event, their representatives and successors, from all claims or liabilities of any kind arising our of my participating in this event even though that liability might arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion picture, or record, of this event for any legitimate purpose.

Please type your full name as your Electronic Signature giving consent to this waiver (required)
(must have Electronic Signature of parent or guardian if participant is under the age of 18)